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DOI: 10.1055/s-0045-1811595
Surgical and Injection Interventions for Dupuytren's Disease: A Systematic Review Protocol
Intervenções cirúrgicas e injetáveis na contratura de Dupuytren: protocolo de revisão sistemáticaAuthors

Abstract
Objective
To compare the effectiveness and safety of surgical and injection-based interventions for Dupuytren's disease (DD) using systematic review and network meta-analysis methodology.
Methods
The current protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and is registered in The International Prospective Register of Systematic Reviews (PROSPERO). Randomized controlled trials involving adult patients with DD treated by surgical (e.g., fasciectomy, fasciotomy) or injection-based interventions (e.g., collagenase, corticosteroids) must be included. A comprehensive search must be conducted across MEDLINE, CENTRAL, EMBASE, LILACS, IBECS, and trial registries, without language or date restrictions. Two reviewers must perform independent screening, data extraction, and risk of bias assessment (RoB2). Primary outcomes must include functional improvement and adverse effects. Secondary outcomes must include recurrence, range of motion, and pain. Data synthesis should involve random-effects pairwise and network meta-analyses, with GRADE used to assess certainty of evidence. Subgroup analyses should explore heterogeneity based on clinical and methodological variables.
Results
This proposal of review aims to generate comparative estimates of effectiveness and safety across all eligible interventions, incorporating both direct and indirect evidence. Functional outcomes must be synthesized using a predefined hierarchy of patient-reported outcome measures (PROMs), and treatments must be ranked based on efficacy and safety profiles.
Conclusion
The present systematic review aims to fill current evidence gaps by comparing all relevant interventions for DD, supporting clinical decision-making through robust synthesis of functional and safety outcomes.
Resumo
Objetivo
Comparar a eficácia e a segurança de intervenções cirúrgicas e injetáveis para tratamento da contratura de Dupuytren (CD) por meio de revisão sistemática e metodologia de metanálise em rede.
Métodos
Este protocolo segue as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) e está registrado no The International Prospective Register of Systematic Reviews (PROSPERO). Devem ser incluídosestudos clínicos randomizados com pacientes adultos com CD e submetidos a intervenções cirúrgicas (ex.: fasciectomia e fasciotomia) ou injetáveis (ex.: colagenase e corticosteroides). Uma busca abrangente deve ser conduzida nas bases de dados MEDLINE, CENTRAL, EMBASE, LILACS, IBECS e registros de estudos clínicos, sem restrições de idioma ou data. Dois revisores devem realizer a triagem, extração de dados e avaliação de risco de viés (RoB2) de forma independente. Os desfechos primários devem incluir melhora funcional e efeitos adversos. Os desfechos secundários devem incluir recidiva, amplitude de movimento e dor. A síntese de dados deve envolver metanálises pareadas e de rede de efeitos aleatórios e a certeza da evidência deve ser avaliada de acordo com a abordagem Grading of Recommendation, Assessment, Development and Evaluation (GRADE). As análises de subgrupos devem explorar a heterogeneidade com base em variáveis clínicas e metodológicas.
Resultados
Esta proposta de revisão pretende gerar estimativas comparativas de eficácia e segurança em todas as intervenções elegíveis, incorporando evidências diretas e indiretas. Os desfechos funcionais devem ser sintetizados usando uma hierarquia predefinida de medidas de desfecho relatadas pelo paciente (PROMs, do inglês patient-reported outcome measures) e os tratamentos devem ser classificados com base nos perfis de eficácia e segurança.
Conclusão
Esta revisão sistemática visa preencher lacunas de evidências atuais comparando todas as intervenções relevantes para o tratamento da CD, apoiando a tomada de decisão clínica por meio de síntese robusta de resultados funcionais e de segurança.
Author Contributions
RGS led the study, overseeing conceptualization, methodology, and review, and is the guarantor of the work. VYM, JBGS, and FF contributed to the study's conceptualization and methodology, and provided critical revisions. VTC and NCJ were responsible for the search strategy and statistical data analysis. All authors contributed to the writing and reviewing of the manuscript and approved the final version.
Financial Support
The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study.
The present work was developed at the Disciplina de Cirurgia da Mão e Membro Superior, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.
Publikationsverlauf
Eingereicht: 14. April 2025
Angenommen: 09. Juni 2025
Artikel online veröffentlicht:
08. September 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil
Rodrigo Guerra Sabongi, Vinicius Ynoe de Moraes, João Baptista Gomes dos Santos, Vinicius Tassoni Civile, Nelson Carvas Junior, Flávio Faloppa. Surgical and Injection Interventions for Dupuytren's Disease: A Systematic Review Protocol. Rev Bras Ortop (Sao Paulo) 2025; 60: s00451811595.
DOI: 10.1055/s-0045-1811595
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References
- 1
Zhang AY,
Kargel JS.
The Basic Science of Dupuytren Disease. Hand Clin 2018; 34 (03) 301-305
Reference Ris Wihthout Link
- 2
Salari N,
Heydari M,
Hassanabadi M.
et al.
The worldwide prevalence of the Dupuytren disease: a comprehensive systematic review
and meta-analysis. J Orthop Surg Res 2020; 15 (01) 495
Reference Ris Wihthout Link
- 3
Alser OH,
Kuo RYL,
Furniss D.
Nongenetic Factors Associated with Dupuytren's Disease: A Systematic Review. Plast
Reconstr Surg 2020; 146 (04) 799-807
Reference Ris Wihthout Link
- 4
Lanting R,
Broekstra DC,
Werker PMN,
van den Heuvel ER.
A systematic review and meta-analysis on the prevalence of Dupuytren disease in the
general population of Western countries. Plast Reconstr Surg 2014; 133 (03) 593-603
Reference Ris Wihthout Link
- 5
Boe C,
Blazar P,
Iannuzzi N.
Dupuytren Contractures: An Update of Recent Literature. J Hand Surg Am 2021; 46 (10)
896-906
Reference Ris Wihthout Link
- 6
Hurst LC,
Badalamente MA,
Hentz VR.
et al;
CORD I Study Group.
Injectable collagenase clostridium histolyticum for Dupuytren's contracture. N Engl
J Med 2009; 361 (10) 968-979
Reference Ris Wihthout Link
- 7
Ketchum LD,
Donahue TK.
The injection of nodules of Dupuytren's disease with triamcinolone acetonide. J Hand
Surg Am 2000; 25 (06) 1157-1162
Reference Ris Wihthout Link
- 8
Denkler KA,
Park KM,
Alser O.
Treatment Options for Dupuytren's Disease: Tips and Tricks. Plast Reconstr Surg Glob
Open 2022; 10 (01) e4046
Reference Ris Wihthout Link
- 9
Denkler KA,
Vaughn CJ,
Dolan EL,
Hansen SL.
Evidence-Based Medicine: Options for Dupuytren's Contracture: Incise, Excise, and
Dissolve. Plast Reconstr Surg 2017; 139 (01) 240e-255e
Reference Ris Wihthout Link
- 10
Shaheen MS,
Karjalainen VL,
Reddy A,
Karjalainen T,
Chung KC.
Effectiveness and Safety of Dupuytren Contracture Treatments: A Systematic Review
and Meta-Analysis Using the GRADE Approach. Plast Reconstr Surg 2024;
Reference Ris Wihthout Link
- 11
Seth I,
McClure V,
Lim B,
Cuomo R,
Ross RJ,
Rozen WM.
Collagenase Clostridium Histolyticum Versus Percutaneous Needle Fasciotomy for Dupuytren's
Disease: A Systematic Review and Meta-Analysis. Life (Basel) 2025; 15 (02) 259
Reference Ris Wihthout Link
- 12
Cevik J,
Rajaram R,
Pollock M,
Seth I,
Rozen WM.
Collagenase clostridium histolyticum for Dupuytren's disease: a comprehensive systematic
review and comparative analysis against percutaneous needle aponeurotomy and limited
fasciectomy. J Plast Surg Hand Surg 2025; 60: 27-34
Reference Ris Wihthout Link
- 13
Soreide E,
Murad MH,
Denbeigh JM.
et al.
Treatment of Dupuytren's contracture: a systematic review. Bone Joint J 2018; 100-B
(09) 1138-1145
Reference Ris Wihthout Link
- 14
Raval P,
Kulkarni K,
Johnson N.
et al
Frequency and Reporting of Complications after Dupuytren Contracture Interventions:
A Systematic Review and Meta-Analysis. Plast Reconstr Surg 2025; 155 (01) 115-125
Reference Ris Wihthout Link
- 15
Nann S,
Kovoor J,
Fowler J.
et al.
Surgical Management of Dupuytren Disease: A Systematic Review and Network Meta-analyses.
Hand (N Y) 2024; 19 (08) 1283-1292
Reference Ris Wihthout Link
- 16
Rodrigues JN,
Becker GW,
Ball C.
et al.
Surgery for Dupuytren's contracture of the fingers. Cochrane Database Syst Rev 2015;
2015 (12) CD010143
Reference Ris Wihthout Link
- 17
Liberati A,
Altman DG,
Tetzlaff J.
et al.
The PRISMA statement for reporting systematic reviews and meta-analyses of studies
that evaluate healthcare interventions: explanation and elaboration. BMJ 2009; 339:
b2700
Reference Ris Wihthout Link
- 18
Moher D,
Shamseer L,
Clarke M.
et al.
PRISMA-P Group.
Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P)
2015 statement. Syst Rev 2015; 4 (01) 1
Reference Ris Wihthout Link
- 19
Mohan A,
Vadher J,
Ismail H,
Warwick D.
The Southampton Dupuytren's Scoring Scheme. J Plast Surg Hand Surg 2014; 48 (01) 28-33
Reference Ris Wihthout Link
- 20
Forget NJ,
Higgins J,
Rivard M,
Harris PG.
Going beyond activity and participation: development of the DIF-CHUM-A patient-reported
outcome measure for individuals with Dupuytren's contracture. J Hand Ther 2020; 33
(03) 305-313
Reference Ris Wihthout Link
- 21
Beaudreuil J,
Allard A,
Zerkak D.
et al.
URAM Study Group.
Unité Rhumatologique des Affections de la Main (URAM) scale: development and validation
of a tool to assess Dupuytren's disease-specific disability. Arthritis Care Res (Hoboken)
2011; 63 (10) 1448-1455
Reference Ris Wihthout Link
- 22
Hudak PL,
Amadio PC,
Bombardier C,
Beaton D,
Cole D,
Davis A..
The Upper Extremity Collaborative Group (UECG).
Development of an upper extremity outcome measure: the DASH (disabilities of the arm,
shoulder and hand) [corrected]. Am J Ind Med 1996; 29 (06) 602-608 Doi: 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L.
Erratum in: Am J Ind Med 1996;30(3):372
Reference Ris Wihthout Link
- 23
Chung KC,
Pillsbury MS,
Walters MR,
Hayward RA.
Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand
Surg Am 1998; 23 (04) 575-587
Reference Ris Wihthout Link
- 24
Duruöz MT,
Poiraudeau S,
Fermanian J.
et al
Development and validation of a rheumatoid hand functional disability scale that assesses
functional handicap. J Rheumatol 1996; 23 (07) 1167-1172
Reference Ris Wihthout Link
- 25
Kan HJ,
Verrijp FW,
Hovius SER,
van Nieuwenhoven CA,
Selles RW..
Dupuytren Delphi Group.
Recurrence of Dupuytren's contracture: A consensus-based definition. PLoS One 2017;
12 (05) e0164849 . Doi: 10.1371/journal.pone.0164849. Erratum in: PLoS One 2019;14(4):e0216313.
Doi: 10.1371/journal.pone.0216313
Reference Ris Wihthout Link
- 26
Desai SS,
Hentz VR.
The treatment of Dupuytren disease. J Hand Surg Am 2011; 36 (05) 936-942
Reference Ris Wihthout Link
- 27
van Rijssen AL,
Werker PM.
Percutaneous needle fasciotomy in Dupuytren's disease. J Hand Surg Br 2006; 31 (05)
498-501
Reference Ris Wihthout Link
- 28
Kan HJ,
Verrijp FW,
Huisstede BM,
Hovius SE,
van Nieuwenhoven CA,
Selles RW.
The consequences of different definitions for recurrence of Dupuytren's disease. J
Plast Reconstr Aesthet Surg 2013; 66 (01) 95-103
Reference Ris Wihthout Link
- 29
Werker PM,
Pess GM,
van Rijssen AL,
Denkler K.
Correction of contracture and recurrence rates of Dupuytren contracture following
invasive treatment: the importance of clear definitions. J Hand Surg Am 2012; 37 (10)
2095-2105.e7
Reference Ris Wihthout Link
- 30
Karpinski M,
Moltaji S,
Baxter C,
Murphy J,
Petropoulos JA,
Thoma A.
A systematic review identifying outcomes and outcome measures in Dupuytren's disease
research. J Hand Surg Eur Vol 2020; 45 (05) 513-520
Reference Ris Wihthout Link
