One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren's contracture: A two-centre prospective randomized clinical trial

Abstract

The objective of this study was to compare early and 1 year outcome of needle fasciotomy and collagenase injection for Dupuytren′s disease. Inclusion criteria were primary Dupuytren's contracture excluding the thumb with a palpable cord and a total extension deficit, i.e. a fixed flexion from 30° to 135° with less than 60° in the proximal interphalangeal joint. The most affected ray was randomized to either treatment at two centres. Passive extension deficits for each joint before and after treatment, and at 3 and 12 months, were recorded together with complications. A total of 96 rays in 93 patients were included. The average total extension deficits before treatment were 60° or more in both groups, and were largely made up of contractures at the metacarpophalangeal joints. The deficits were reduced by 75% in both groups at 3 months and by 70% in both groups at 12 months. Four patients in the needle fasciotomy group and eight patients in the collagenase group had skin ruptures. At 3 months and 1 year, the outcomes of needle fasciotomy and collagenase injection are the same in Dupuytren's disease with predominantly metacarpophalangeal joint involvement.