title: Examining the efficacy and maintenance of contracture correction after collagenase clostridium histolyticum treatment for Dupuytren's disease.
abstract: BACKGROUND
  This study examined the efficacy, complications, and contracture recurrence in patients who received injectable collagenase clostridium histolyticum (CCH) for Dupuytren's-induced metacarpophalangeal (MP) and proximal interphalangeal (PIP) joint contractures.
  
  
  METHODS
  A retrospective chart review at one center compared the degree of MP and PIP joint contracture pre-injection, post-cord rupture, and at final follow-up after a minimum duration of 6 months. Recurrence was defined as a 20 ° or greater increase in contracture above the minimum value achieved.
  
  
  RESULTS
  Of 102 eligible patients, 48 patients (47 %) (31 males, 17 females) were available for review. 53 digits and 64 joints (46 MP joints and 18 PIP joints) were studied. The mean patient age was 66 years (range, 48-87 years) and mean follow-up duration was 15 months (range, 6 to 25 months). The mean MP joint contracture was 51 ± 20 ° at baseline, 4 ± 8 ° post-cord rupture, and 9 ± 15 ° at latest follow-up. The mean PIP joint contracture was 39 ± 23 ° at baseline, 14 ± 14 ° at cord rupture, and 29 ± 20 ° at latest follow-up. Of the 46 MP joints and 18 PIP joints, 11 MP (24 %) and 7 (39 %) PIP joints met the recurrence criteria. Of 102 patients, 1 patient had a small finger flexor tendon rupture.
  
  
  CONCLUSIONS
  Despite the dramatic initial reduction in contracture, recurrence developed in a high proportion of patients over the study period. While initially effective, CCH may not provide durable contracture reduction. However, CCH remains a viable nonsurgical treatment for Dupuytren's disease.
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, 700 South Henderson Road, Suite 200, King of Prussia, PA 19406 USA.
authors.forename: Heather A
authors.initials: HA
authors.lastname: McMahon
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, 700 South Henderson Road, Suite 200, King of Prussia, PA 19406 USA.
authors.forename: Abdo
authors.initials: A
authors.lastname: Bachoura
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, 700 South Henderson Road, Suite 200, King of Prussia, PA 19406 USA.
authors.forename: Sidney M
authors.initials: SM
authors.lastname: Jacoby
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, 700 South Henderson Road, Suite 200, King of Prussia, PA 19406 USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Zelouf
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, 700 South Henderson Road, Suite 200, King of Prussia, PA 19406 USA.
authors.forename: Randall W
authors.initials: RW
authors.lastname: Culp
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, 700 South Henderson Road, Suite 200, King of Prussia, PA 19406 USA.
authors.forename: A Lee
authors.initials: AL
authors.lastname: Osterman
keywords: Collagenase; Dupuytren’s disease; Recurrence