Collagenase treatment of Dupuytrens contracture using a modified injection method

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Atroshi, IsamLund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Department Orthoped, Sweden; Ystad Hospital, Sweden; Lund University, Sweden (författare)

Collagenase treatment of Dupuytrens contracture using a modified injection method

Artikel/kapitelEngelska2015

Förlag, utgivningsår, omfång ...

2015-02-19
Informa Healthcare: Creative Commons Attribution Non-Commercial / Informa Healthcare,2015
electronicrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:liu-120056
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-120056URI
https://doi.org/10.3109/17453674.2015.1019782DOI
https://lup.lub.lu.se/record/7605067URI

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Språk:engelska
Sammanfattning på:engelska

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Funding Agencies|Hassleholm Hospital
Background and purpose - Treatment of Dupuytrens contracture (DC) with collagenase Clostridium histolyticum (CCH) consists of injection followed by finger manipulation. We used a modified method, injecting a higher dose than recommended on the label into several parts of the cord, which allows treatment of multiple joint contractures in 1 session and may increase efficacy. We studied the occurrence of skin tears and short-term outcome with this procedure. Patients and methods - We studied 164 consecutive hands with DC, palpable cord, and extension deficit of greater than= 20 degrees in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint (mean patient age 70 years, 82% men). A hand surgeon injected all the content of 1 CCH vial (approximately 0.80 mg) into multiple spots in the cord and performed finger extension under local anesthesia after 1 or 2 days. A nurse recorded skin tears on a diagram and conducted a standard telephone follow-up within 4 weeks. A hand therapist measured joint contracture before injection and at a median of 23 (IQR: 7-34) days after finger extension. Results - A skin tear occurred in 66 hands (40%). The largest diameter of the tear was less than= 5 mm in 30 hands and greater than 10 mm in 14 hands. Hands with skin tear had greater mean pretreatment MCP extension deficit than those without tear: 59 degrees (SD 26) as opposed to 32 degrees (SD 23). Skin tear occurred in 21 of 24 hands with MCP contracture of greater than= 75 degrees. All tears healed with open-wound treatment. No infections occurred. Mean improvement in total (MCP + PIP) extension deficit was 55 degrees (SD 28). Interpretation - Skin tears occurred in 40% of hands treated with collagenase injections, but only a fifth of them were larger than 1 cm. Tears were more likely in hands with severe MCP joint contracture. All tears healed without complications. Short-term contracture reduction was good.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng

Biuppslag (personer, institutioner, konferenser, titlar ...)

Nordenskjöld, JesperLund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Department Orthoped, Sweden; Ystad Hospital, Sweden; Lund University, Sweden(Swepub:lu)med-jnj (författare)
Lauritzson, AnnaDepartment Orthoped, Sweden; Ystad Hospital, Sweden (författare)
Ahlgren, EvaDepartment Orthoped, Sweden; Ystad Hospital, Sweden (författare)
Waldau, JohannaDepartment Orthoped, Sweden; Ystad Hospital, Sweden (författare)
Waldén, MarkusLinköpings universitet,Avdelningen för samhällsmedicin,Medicinska fakulteten,Department Orthoped, Sweden; Ystad Hospital, Sweden(Swepub:liu)marwa97 (författare)
Ortopedi, LundSektion III (creator_code:org_t)

Sammanhörande titlar

Ingår i:Acta Orthopaedica: Informa Healthcare: Creative Commons Attribution Non-Commercial / Informa Healthcare86:3, s. 310-3151745-36741745-3682

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Av författaren/redakt...: Atroshi, Isam; Nordenskjöld, Je ...; Lauritzson, Anna; Ahlgren, Eva; Waldau, Johanna; Waldén, Markus

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Ortopedi

Artiklar i publikationen: Acta Orthopaedic ...

Av lärosätet: Linköpings universitet; Lunds universitet

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