Injectable Collagenase Clostridium Histolyticum: A New Nonsurgical Treatment for Dupuytren's Disease

Gilpin, David; Coleman, Stephen; Hall, Stephen; Houston, Anthony; Karrasch, Jeff; Jones, Nigel

doi:10.1016/j.jhsa.2010.08.007

Cited by 297 publications

(378 citation statements)

References 26 publications

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“…The answers to the most frequent adverse events and side effects (90% of the participants observed bleeding, pain, swelling, tenderness and haematoma, 85% skin tears, 45% lymph node swelling and lymphangitis, 40% joint swelling and pain, 25% efflorescence of the skin, 15% pruritus and 5% tendon rupture) are also comparable with the existing literature such as the CORD I and II studies [35,36,39].…”

Section: Discussionsupporting

confidence: 82%

“…Primarily, the doctors take measurements by use of a goniometer. This is also seen in several studies including the ones by Gilpin et al (2010) and , in which the range of motion (ROM) was one of the most important postoperative outcome measures [3,36,43].…”

Section: Discussionmentioning

confidence: 60%

“…For a better outcome, they are instructed to wear a night splint for up to 4 months and perform daily extension and flexion exercises. Follow-up visits take place on the 1st, 7th and 30th day after the injection [35][36][37][38].…”

Section: Treatment With Collagenase Clostridium Histolyticummentioning

confidence: 99%

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Dupuytren’s contracture: the status and impact of collagenase Clostridium histolyticum treatment in Austria

et al. 2017

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Background: Over many decades, the treatment of Dupuytren's disease, a fibroproliferative disease of the hand, is the centre of various studies and publications. Surgical intervention has always been the method of choice, with fasciectomy being today's state of the art. Nevertheless, researchers also focused on conservative non-operative treatment methods of which collagenase Clostridium histolyticum (CCH) turned out to be very promising. With the release of CCH under the name Xiapex in 2010, its use increased steadily. The aim of this work is to survey the current state of the treatment with CCH and the status of Xiapex treatment in Austria. Methods: On behalf of the Division of Plastic, Aesthetic and Reconstructive Surgery at the Medical University of Graz, a questionnaire was sent out to departments and doctors in Austria that are treating Dupuytren's disease. Based on this expert interrogation data concerning treating patterns, complications, outcome, etc. has been collected.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 60%

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Dupuytren’s contracture: the status and impact of collagenase Clostridium histolyticum treatment in Austria

et al. 2017

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“…Muscles innervated below the lesion are paralysed as a result of an upper motor neuron (UMN) paralysis (1). The authors propose that there is also a component of LMN injury in muscles innervated below the lesion.…”

Section: Purposementioning

confidence: 99%

Hand Surgery Program Abstracts

2014

ANZ Journal of Surgery

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Background:The operation scheme of fi nger reconstruction is based on manual measurement and visual estimate at present. The surgery is thus exposed to a large amount of randomness, blindness, and depending on the personal experience of the surgeon, his habits and subjective inclinations, as well as the diverse conditions of the blood supply of donor site, the outcome of the surgery can be greatly affected by these factors. Methods: Toe to hand reconstructive surgeries on 103 patients (123 fi ngers) were aided by preoperative and intra-operative analysis of the blood supply of donor site through CT angiography, computer aided design and 3D printing. Results: One hundred and twenty three fi ngers survived. The successful rate was 100%. Among them, 93 patients (111 fi ngers) had been followed up from 5 to 24 months postoperatively. The appearance of reconstructed fi ngers, static two-point discrimination, total active range of motion, and pinch strength were generally excellent. The majority of the patients were satisfi ed with the fi nal outcome. Conclusion:The aid of digital medicine technology in the reconstruction surgery of thumb and fi nger defect can greatly reduce the blindness and unpredictability, as well as contribute to the more ideal appearance, higher survival rate and better outcomes. HS04 SUPRASCAPULAR NERVE RECONSTRUCTION IN OBSTETRIC BRACHIAL PLEXUS PALSYM itchel S eruya , S hi H ong S hen , S ibon F uzzard , K eith M utimer , D avid M ccombe and B ruce J ohnstone Royal Children ' s Hospital Melbourne, VictoriaIntroduction: The purpose of this study was to evaluate the long-term shoulder function of patients undergoing suprascapular nerve (SSN) reconstruction via cervical root grafting versus spinal accessory nerve transfer. Methods: A retrospective review was performed of all infants treated for OBPP between 1995-2010. Inclusion criteria consisted of infants who underwent suprascapular nerve reconstruction and with preoperative and ≥ 36-month postoperative outcome data. Patients were categorized by the type of SSN reconstruction (graft versus transfer) and compared. Results: 74 patients met the inclusion criteria (46 transfers, 28 grafts). Preoperatively, both groups presented with median Toronto AMS scores of 2.0 for shoulder ABD and 0.0 for ER. Median postoperative follow-up was 9.0 years for grafts and 6.7 years for transfers. Both groups achieved a median AMS score of 5.0 for shoulder ABD at 12, 24, and 36 months postoperatively. Median AMS scores for shoulder ER was 1.0, 2.0, and 2.5 for grafts versus 2.0, 2.0, and 3.0 for transfers at 12 months, 24 months, and 36 months postoperatively. None of these differences reached statistical signifi cance. Composite Mallet scores were 13.3 for grafts versus 15.1 for transfers at 3-years postoperatively ( p < 0.05) and 13.7 for grafts versus 15.3 for transfers at 5-years postoperatively ( p = 0.07). The frequency of secondary shoulder surgery was 57.1% (16 of 28) for grafts and 26.1% (12 of 46) for transfers (OR 3.17, p = 0.02). Conclusions: Suprasca...

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“…Se han realizado estudios prospectivos, comparados con placebo, con seguimiento hasta 2 años [30][31][32] así como estudios retrospectivos con mayores seguimientos (8 años) 33 , que muestran una efectividad de aproximadamente 65% en la resolución completa (0-5° de contractura remanente) de la contractura con el uso de esta enzima con un máximo de 3 inyecciones. Se puede utilizar en las contracturas de cualquier grado, sin embargo, hay una mejor respuesta en las articulaciones MTCF que en las IFP y mientras mayor sea la contractura inicial de la articulación, peor es la respuesta a la inyección.…”

Section: Tratamiento No Quirúrgicounclassified

Enfermedad de Dupuytren: revisión

2012

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Dupuytren disease (DD) is a connective tissue disorder that consists in fibromatosis of the palmar and digital fascia (in form of nodules or flanges) that leads to theL a enfermedad de Dupuytren (ED) es una condición benigna del tejido conectivo, caracterizado por un desorden fibroproliferativo (fibromatosis benigna) que afecta fundamentalmente a la aponeurosis palmar y digital, provocando contracturas y deformidad progresiva en flexión en la región palmar de mano y dedos, cuya causa y mecanismo fisiopatológico aún permanecen parcialmente comprendidos.El primer caso de esta condición fue descrito por el médico suizo Félix Plater en 1614 (quien le atribuyó una causa traumática), siendo luego descrito por otros autores como H Cline, en 1777 y por Ashley Cooper, en 1822; sin embargo, el nombre del médico francés Guillaume Dupuytren predominó para esta condición, quien en 1831 describe en detalle la fibromatosis localizada en la aponeurosis palmar, realizando la primera cirugía de fasciotomía abierta.Esta enfermedad se caracteriza por el desarrollo de contracturas en flexión, de la palma y de las articulaciones digitales, secundaria a la formación de nódulos y bandas fibrosas o bridas [1][2][3][4][5] . Afecta principalmente la región palmar distal en relación a los dedos anular y meñique, produciendo la flexión progresiva e irreversible de las articulaciones metacarpo-falángicas (MTCF) e interfalángicas proximales (IFP). EpidemiologíaEn relación a la prevalencia de esta enfermedad, destaca que es un cuadro que sucede en toda la población, pero en diferente proporción y frecuencia dependiendo de la carga genética y de las comorbilidades del paciente. La incidencia de esta patología aparece mayor en los países del norte de Europa y emigrantes provenientes de esas zonas; mientras que es rara en países africanos y Asia oriental. La prevalencia reportada en otros países es de 1,7 a 2% en varones adultos mayores de 50 años en la población general, siendo de 3-6% en adultos caucásicos. En Escocia, Noruega e Islandia se ha reportado una incidencia de hasta 40% en ciertas comunidades, mientras que su presencia en poblaciones de raza negra y de Asia oriental es de escasa ocurrencia. Es siete a diez veces más frecuente en hombres que en mujeres. Para esto aún no hay explicación, sin embargo los miofibroblastos en la ED tienen una mayor expresión de

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Injectable Collagenase Clostridium Histolyticum: A New Nonsurgical Treatment for Dupuytren's Disease

Cited by 297 publications

References 26 publications

Dupuytren’s contracture: the status and impact of collagenase Clostridium histolyticum treatment in Austria

Dupuytren’s contracture: the status and impact of collagenase Clostridium histolyticum treatment in Austria

Hand Surgery Program Abstracts

Enfermedad de Dupuytren: revisión

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