Abstract
Introduction The aim of this study was to assess the rate of additional treatment after collagenase
injection and needle fasciotomy, and what factors are associated with additional procedures
for recurrence.
Materials and Methods We retrospectively identified 201 adult patients who underwent collagenase injection
and 19 patients who underwent needle fasciotomy for Dupuytren’s disease from 2012
to 2014. Outcomes included additional treatment of the same ray for either recurrence
or persistence of contracture. To evaluate associated factors, we performed a bivariate
analysis.
Results Additional treatment after collagenase injection for recurrence was performed in
24% of fingers at a median of 23 months (interquartile range [IQR]: 10.8–36.1) and
was associated with bilateral disease (p = 0.008). Additional treatment for persistence was performed in 5.6% at a median
of 1.9 months (IQR: 1.1–3.2). Additional treatment for recurrence after needle fasciotomy
was performed in 13% of fingers at a median of 28.2 months (IQR: 27.5–28.2) and 4.2%
for persistence at 1.1 months. Fingers treated with needle fasciotomy were more likely
to undergo secondary open fasciectomy (13% vs. 5.1%, p = 0.022).
Conclusion Additional treatment after collagenase injections was performed in 29% of fingers,
mostly another collagenase injection, and was associated with bilateral disease. After
needle fasciotomy, 17% of patients underwent additional treatment, primarily open
partial fasciectomy.
Keywords
collagenase - clostridium histolyticum - xiaflex - needle fasciotomy - aponeurotomy
- dupuytren - contracture
