J Hand Microsurg 2022; 14(02): 138-146
DOI: 10.1055/s-0040-1713947
Original Article

Additional Treatment after Collagenase Injections and Needle Fasciotomy for Dupuytren’s Disease: A Retrospective Cohort Study

1   Department of Orthopaedic Surgery, Hand & Arm Center, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Jonathan Lans
1   Department of Orthopaedic Surgery, Hand & Arm Center, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Ritsaart Westenberg
1   Department of Orthopaedic Surgery, Hand & Arm Center, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Kiera Lunn
1   Department of Orthopaedic Surgery, Hand & Arm Center, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Philip Blazar
1   Department of Orthopaedic Surgery, Hand & Arm Center, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Neal C. Chen
1   Department of Orthopaedic Surgery, Hand & Arm Center, Massachusetts General Hospital, Boston, Massachusetts, United States
› Author Affiliations

Abstract

Introduction The aim of this study was to assess the rate of additional treatment after collagenase injection and needle fasciotomy, and what factors are associated with additional procedures for recurrence.

Materials and Methods We retrospectively identified 201 adult patients who underwent collagenase injection and 19 patients who underwent needle fasciotomy for Dupuytren’s disease from 2012 to 2014. Outcomes included additional treatment of the same ray for either recurrence or persistence of contracture. To evaluate associated factors, we performed a bivariate analysis.

Results Additional treatment after collagenase injection for recurrence was performed in 24% of fingers at a median of 23 months (interquartile range [IQR]: 10.8–36.1) and was associated with bilateral disease (p = 0.008). Additional treatment for persistence was performed in 5.6% at a median of 1.9 months (IQR: 1.1–3.2). Additional treatment for recurrence after needle fasciotomy was performed in 13% of fingers at a median of 28.2 months (IQR: 27.5–28.2) and 4.2% for persistence at 1.1 months. Fingers treated with needle fasciotomy were more likely to undergo secondary open fasciectomy (13% vs. 5.1%, p = 0.022).

Conclusion Additional treatment after collagenase injections was performed in 29% of fingers, mostly another collagenase injection, and was associated with bilateral disease. After needle fasciotomy, 17% of patients underwent additional treatment, primarily open partial fasciectomy.

Supplementary Material



Publication History

Article published online:
26 July 2020

© 2020. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

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