Range of motion, postoperative rehabilitation and patient satisfaction in MCP and PIP joints affected by Dupuytren Tubiana stage 1–3: collagenase enzymatic fasciotomy or limited fasciectomy? A clinical study in 52 patients

• Published in: Archives of orthopaedic and trauma surgery 2018-11, Vol.138 (11), p.1623-1631
• Main Authors: Leclère, Franck M., Kohl, Sabine, Varonier, Cédric, Unglaub, Frank, Vögelin, Esther
• Format: Article
• Language: English
• Subjects: Aged; Dupuytren Contracture - rehabilitation; Dupuytren Contracture - therapy; Fasciotomy - adverse effects; Fasciotomy - methods; Female; Follow-Up Studies; Hand Joints - pathology; Hand Joints - surgery; Handsurgery; Humans; Joint Dislocations - surgery; Male; Medicine; Medicine & Public Health; Microbial Collagenase - adverse effects; Microbial Collagenase - therapeutic use; Middle Aged; Orthopedics; Patient satisfaction; Patient Satisfaction - statistics & numerical data; Physical Therapy Modalities - statistics & numerical data; Postoperative period; Range of Motion, Articular - physiology; Rehabilitation; Retrospective Studies; Surgery; Switzerland; Treatment Outcome
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-018-3034-6

Introduction In Switzerland, collagenase Clostridium histolyticum therapy (CCH) for Dupuytren’s disease was introduced in 2011. This study analyzes possible differences between CCH and limited fasciectomy (LF) in terms of range of motion, patient satisfaction and postoperative rehabilitation. Materials and methods This retrospective study included 52 patients with Dupuytren’s disease stage 1–3 according to Tubiana, treated with CCH or LF between January 2012 and December 2013. Complications were analyzed for each patient. The contracture of each treated joint measured on average at the 3 months and up to 2 years follow-up was compared with the preoperative values. The Michigan Hand score was evaluated at 2 years and the patients were asked to subjectively evaluate the outcome of the treatment and whether they would repeat it if necessary. Postoperative rehabilitation was also precisely quantified. Results 11 minor complications were reported for a complication rate of 29% in the CCH group. No major complications were reported in both groups. In the CCH group, mean MCP joint contracture was, respectively, 44° ± 20°, 9° ± 2° (gain of mobility compared to the preoperative situation 35°, P