The effectiveness of manipulation of fingers with Dupuytren's contracture 7 days after collagenase clostridial histolyticum injection. (March 2020)

• Record Type: Journal Article
• Authors: Reynolds, Bethany; Tobin, Vicky; Smith, Julian A; Rozen, Warren M; Hunter-Smith, David J.
• Is Part Of: Journal of hand surgery. Volume 45:Number 3(2020)
• Page Start: 286
• Page End: 291
• Publication Date: 2020-03
• Subjects: Collagenase -- delayed manipulation -- Dupuytren's -- patient-reported outcomes; 617.575059
• DOI: 10.1177/1753193419890770
• Languages: English
• ISSNs: 1753-1934

Abstract

Timing of manipulation of digits after collagenase injection for Dupuytren's disease varies and often takes place within the first few days post-injection. We prospectively investigated the effectiveness of performing manipulation under local anaesthesia 7 days after injection in 100 patients. Demographic data, passive extension deficit, and patient-reported outcome measures were recorded before collagenase injection. Four to 7 weeks after manipulation, passive extension deficit and patient-reported outcome measures improved significantly without the development of any tendon ruptures. Clinical success was achieved in 41% and clinical improvement in 76% of the patients. Adverse events were reported by 85%. The outcomes were comparable with studies with early manipulation, and demonstrate a safe and effective variation to current protocols. We conclude that delaying manipulation to 7 days after collagenase injection is safe and efficient, which allows for flexibility in clinical appointments without negatively affecting outcome. Level of evidence: III