Recurrence of Dupuytren’s disease (DD) after treatment

Kan, Hester J.; Verrijp, Frank W.; Hovius, Steven E.R.; Nieuwenhoven, Christianne A. van; Selles, Ruud W.

doi:10.32388/437762

Cited by 2 publications

(2 citation statements)

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“…Onset of Dupuytren's disease < 50 years, younger age at treatment, familial predisposition, ectopic lesions, Collagenase Injections and Needle Fasciotomy for Dupuytren's Disease Arnold et al diabetes mellitus, and epilepsy have been suggested to influence recurrence. 7,12,22,23 In this study, age was not found to be associated with additional treatment for recurrence (►Tables 3 and 6). Although younger age might influence recurrence, this may not lead to additional treatment.…”

Section: Discussionmentioning

confidence: 46%

Additional Treatment after Collagenase Injections and Needle Fasciotomy for Dupuytren’s Disease: A Retrospective Cohort Study

Arnold

Lans

Westenberg

et al. 2022

Journal of Hand and Microsurgery

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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.

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Section: Discussionmentioning

confidence: 46%

Additional Treatment after Collagenase Injections and Needle Fasciotomy for Dupuytren’s Disease: A Retrospective Cohort Study

Arnold

Lans

Westenberg

et al. 2022

Journal of Hand and Microsurgery

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“…Recurrence was defined as the occurrence of >20 degrees of deformity after treatment. 12 13 Moreover, an ultrasound evaluation was performed 12 months after treatment to assess the recurrence of the disease. 8…”

Section: Methodsmentioning

confidence: 99%

Dupuytren's Disease: A Novel Minimally Invasive Pull-Through Technique

Maruccia,

Tedeschi,

Sisto

et al. 2024

Arch Plast Surg

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Background Dupuytren's disease decreases quality of life significantly and often requires surgical treatment, nevertheless there is no actual gold standard. The aim of this study was to introduce the use of minimally invasive pull-through technique. Methods From 2016 to 2020, 52 patients suffering from Dupuytren's contracture were treated with the minimally invasive pull-through technique. We evaluated the improvement in range of motion, pain, disability, and quality of life in the long term. Total extension deficit, quick disabilities of the arm, shoulder, and hand (QuickDASH), and EuroQol five dimensions—five levels index were systematically scored before each surgical intervention and reevaluated after 24 months. Results Fourteen patients (26.9%) had already received a previous intervention (percutaneous needle aponeurotomy or collagenase Clostridium histolyticum). The mean preoperative total active extension deficit was 84.0 ± 23.3 degrees (55–130 degrees). Mean follow-up was 36 months. There were no cases of tendon rupture or neurovascular injury. Total active extension deficit at the final follow-up was 3.4 ± 2.3 degrees (0–12 degrees). The mean active range of motion of the MCP and PIP joints were, respectively, 90.5 ± 3.3 degrees (85–96 degrees) and 82.7 ± 2.5 degrees (80–87 degrees). At 24 months after cord excision, a mean 10.7 points improvement in the QuickDASH questionnaire was registered (p < 0.001). Pull-through technique was equally effective both on patients with a primary or a recurrent disease. Eight patients (15.4%) had a recurrence of disease in the metacarpophalangeal joint or proximal interphalangeal joint. Conclusion The pull-through technique is a simple, accessible, and effective technique for the treatment of Dupuytren's contracture. The use of palmar mini-incisions combined with minimal dissection has a low risk of iatrogenic injury to the neurovascular bundles and tendons, and has a low risk of recurrence rate. This study reflects level of evidence IV.

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Recurrence of Dupuytren’s disease (DD) after treatment

Cited by 2 publications

References 1 publication

Additional Treatment after Collagenase Injections and Needle Fasciotomy for Dupuytren’s Disease: A Retrospective Cohort Study

Additional Treatment after Collagenase Injections and Needle Fasciotomy for Dupuytren’s Disease: A Retrospective Cohort Study

Dupuytren's Disease: A Novel Minimally Invasive Pull-Through Technique

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