A comparison of percutaneous needle fasciotomy and collagenase injection for dupuytren disease.
OBJECTIVE
To compare percutaneous needle fasciotomy (PNF) with collagenase injection in the treatment of Dupuytren contracture.


METHODS
A retrospective review was performed for patients with Dupuytren disease treated with PNF or collagenase. Range of motion, patient satisfaction, and complications were recorded.


RESULTS
There were 29 patients in the collagenase group with mean baseline contractures of 40° for 22 affected metacarpophalangeal joints and 50° for 12 affected proximal interphalangeal joints. The PNF group was composed of 30 patients with mean baseline contractures of 37° for 32 affected metacarpophalangeal joints and 41° for 18 affected proximal interphalangeal joints. All patients were observed for a minimum of 3 months. Clinical success (reduction of contracture within 0° to 5° of normal) was accomplished in 35 of 50 joints (67%) in the PNF group and in 19 of 34 joints (56%) in the collagenase group. Patient satisfaction was similar between groups. Only minor complications were observed, including skin tears, ecchymosis, edema, pruritus, and lymphadenopathy.


CONCLUSIONS
In the short term, both PNF and collagenase have similar clinical outcomes and patient satisfaction.


METHODS
Therapeutic III.
Florida Orthopaedic Institute and the Foundation for Orthopaedic Research and Education (FORE), Tampa, FL. Electronic address: orthojason@me.com.
Jason A
JA
Nydick
Bailee W
BW
Olliff
Michael J
MJ
Garcia
Alfred V
AV
Hess
Jeffrey D
JD
Stone
D000368:Aged; D015331:Cohort Studies; D004387:Dupuytren Contracture / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D003012:Microbial Collagenase / Q000627:therapeutic use*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D003012:Microbial Collagenase
Dupuytren; collagenase; percutaneous needle fasciotomy