WHAT IS THE BETTER TREATMENT FOR SINGLE DIGIT DUPUYTREN'S CONTRACTURE: SURGICAL RELEASE OR COLLAGENASE CLOSTRIDIUM HISTOLYTICUM (XIAPEX) INJECTION?

Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand

PubMedID: 25155703

Povlsen B, Povlsen SD. WHAT IS THE BETTER TREATMENT FOR SINGLE DIGIT DUPUYTREN'S CONTRACTURE: SURGICAL RELEASE OR COLLAGENASE CLOSTRIDIUM HISTOLYTICUM (XIAPEX) INJECTION?. Hand Surg. 2014;1-4.
The purpose of this study was to compare the initial and final outcome range of motion in the MCP-J and PIP-J of single digit Dupuytren's Contracture treated with either open surgical excision or manipulation after collagenase clostridium histolyticum (CCH; Xiapex) injection. Material: Ten patients in either group. The range of motion measurements were statistically compared using the student t-test with a p-value of 0.05. There was no statistical difference in the pre-treatment status of the total active range of movement (TAM) between the two groups. Results: Open surgical release achieved a statistically better initial outcome in combined total passive range of movement than the xiapex group (p = 0.0047), but at the final outcome the better TAM measurement at the MCP-J after surgery was not statistically significant. However, the total active range of movement was statistically better at the PIP-J level in the xiapex group (p = 0.01) and the MCP-J and PIP-J combined total active range of movement was statistically better in the xiapex group (p = 0.0258). Conclusion: Surgery achieved better initial outcome at both MCP-J and PIP-J levels, and at discharge, only extension in the MCP-J level was statistically better after open excision. However the final outcome was statistically better at the PIP-J level in extension (p = 0.006) and total active movement (TAM) (p = 0.008) after treatment with collagenase clostridium histolyticum. Further studies are required to assess the long-term differences between the two groups and to investigate the outcomes for patients with multi-digit involvement.