Elrouby, M., Abdelsalam, A., Gad, A., Rizq, K. (2019). Efficacy of Injectable Collagenase in the Treatment of Dupuytren's Contracture in Comparison to Partial Fasciectomy. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(2), 191-195. doi: 10.21608/ejprs.2019.64914
Mohamed Elrouby; Ahmed Abdelsalam; Ahmed Gad; Khaled Rizq. "Efficacy of Injectable Collagenase in the Treatment of Dupuytren's Contracture in Comparison to Partial Fasciectomy". The Egyptian Journal of Plastic and Reconstructive Surgery, 43, 2, 2019, 191-195. doi: 10.21608/ejprs.2019.64914
Elrouby, M., Abdelsalam, A., Gad, A., Rizq, K. (2019). 'Efficacy of Injectable Collagenase in the Treatment of Dupuytren's Contracture in Comparison to Partial Fasciectomy', The Egyptian Journal of Plastic and Reconstructive Surgery, 43(2), pp. 191-195. doi: 10.21608/ejprs.2019.64914
Elrouby, M., Abdelsalam, A., Gad, A., Rizq, K. Efficacy of Injectable Collagenase in the Treatment of Dupuytren's Contracture in Comparison to Partial Fasciectomy. The Egyptian Journal of Plastic and Reconstructive Surgery, 2019; 43(2): 191-195. doi: 10.21608/ejprs.2019.64914
Efficacy of Injectable Collagenase in the Treatment of Dupuytren's Contracture in Comparison to Partial Fasciectomy
The Department of Plastic Reconstructive & Maxillofacial Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abstract
Background: Dupuytren's disease as a benign fibroproliferative disease with an abnormal slowly progressive thickening and shorting of the palmar aponeurosis leads to severe functional limitations in the finger movements particularly of the Metacarpophalangeal (MCP) joints and/or the Proximal Interphalangeal (PIP) joints. The authors aimed to evaluate the role of injectable collagenase (CCH) in the treatment of Dupuytren's contracture in comparison to surgical treatment. Material and Methods: This study included 15 patients (33 rays), they were divided into two groups, Group A: 26 rays underwent open fasciectomy. (10 patients) and Group B: 7 rays were treated by collagenase injection. (5 patients). Exclusion criteria for group B were contraindications of injection of CCH. The primary efficacy variable was clinical success, contracture correction to within 5º of normal (normal =0º) by using goniometry. Additional efficacy variables included the time and number of injections required to achieve success in the primary joint. Recurrence rate and adverse effects were recorded. Results: Initial clinical experience was recorded of 5 patients (7 rays) (mean age 57 years) and compared to previously surgically managed 10 patients (26 rays) (mean age 59 years). Of all population, 51% for little, 47% for ring, 1% for middle and 1% for index fingers. The mean of the preintervention fixed flexion contracture in the MCP joint was 39º and improved to one-year postintervention 14º, and in the PIP joint 47º to 19º. In group B one ray with no improvement at all and recurrence in one ray. Partial stretching was achieved in one ray. No serious complications were observed after injections. In cases of group A (26 rays) that was treated by partial fasciectomy, recurrence occurred in 6 rays and nerve injuries as nerve division and neuropraxia occurred in 2 rays. Conclusion: The treatment of Dupuytren's disease with injectable collagenase is safe and effective. However, the financial aspects should be considered especially in developing
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