title: 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.
  
  
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authors.affiliation: Department of Translational Medicine - Hand Surgery, Lund University, Lund, Sweden Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden peter.scherman@med.lu.se.
authors.forename: P
authors.initials: P
authors.lastname: Scherman
authors.affiliation: Department of Hand & Plastic Surgery, Norrlands University Hospital, Umeå, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Jenmalm
authors.affiliation: Department of Translational Medicine - Hand Surgery, Lund University, Lund, Sweden Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
authors.forename: L B
authors.initials: LB
authors.lastname: Dahlin
mesh_terms: D000368:Aged; D017364:Collagenases / Q000627:therapeutic use*; D004387:Dupuytren Contracture / Q000628:therapy*; D000071938:Fasciotomy / Q000295:instrumentation*; D005260:Female; D005384:Finger Joint; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008662:Metacarpophalangeal Joint; D008875:Middle Aged; D009339:Needles; D011446:Prospective Studies; D016059:Range of Motion, Articular; D016896:Treatment Outcome
chemical_list: D017364:Collagenases
keywords: Dupuytren′s disease; collagenase injection; needle fasciotomy; randomized controlled trial