Efficacy and safety of collagenase Clostridium histolyticum injection for Dupuytren contracture: report of 40 cases
详细信息 查看全文
- 作者：F. Alberton (1)
M. Corain (1)
A. Garofano (1)
L. Pangallo (1)
A. Valore (1)
V. Zanella (1)
R. Adani (1) (2) - 关键词：Collagenase injection ; Dupuytren ; Clostridium Histolyticum ; Nonsurgical treatment
- 刊名：MUSCULOSKELETAL SURGERY
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：98
- 期：3
- 页码：225-232
- 全文大小：535 KB
- 参考文献：1. Canale ST (2003) Campbell’s Operative Orthopaedics, vol 4, 10th edn.
2. Rayan GM (2007) Dupuytren’s disease: anatomy, pathology, presentation, and treatment. J Bone Joint Surg Am 89(1):189-98
3. Shaw RB Jr, Chong AK, Zhang A, Hentz VR, Chang J (2007) Dupuytren’s disease: history, diagnosis, and treatment. Plast Reconstr Surg 120(3):44-4 CrossRef
4. Smith AC (1991) Diagnosis and indications for surgical treatment. Hand Clin 7:635-42
5. Mafi R, Hindocha S, Khan W (2012) Recent surgical and medical advances in the treatment of Dupuytren’s disease—a systematic review of the literature. Open Orthop J 6(Suppl 1:M9):77-2 CrossRef
6. Crean SM, Gerber RA, Le Graverand MP, Boyd DM, Cappelleri JC (2011) The efficacy and safety of fasciectomy and fasciotomy for Dupuytren’s contracture in European patients: a structured review of published studies. J Hand Surg Eur Vol 36:396-07 CrossRef
7. Witthaut J, Jones G, Skrepnik N, Kushner H, Houston A, Lindau TR (2013) Efficacy and safety of collagenase / Clostridium histolyticum injection for Dupuytren contracture: short-term results from 2 open-label studies. J Hand Surg 38(1):2-11
8. Chen NC, Srinivasan RC, Shauver MJ, Chung KC (2011) A systematic review of outcomes of fasciotomy, aponeurotomy, and collagenase treatments for Dupuytren’s contracture. Hand 6(3):250-55 CrossRef
9. Werker PM, Pess GM, van Rijssen AL, Denkler K (2012) Correction of contracture and relapse rates of Dupuytren contracture following invasive treatment: the importance of clear definitions. J Hand Surg Am 37(10):2095-105 CrossRef
10. Tripoli M, Cordova A, Moschella F (2010) The ‘‘Jacobsen Flap’-technique: a safe, simple surgical procedure to treat Dupuytren disease of the little finger in advanced stage. Tech Hand Up Extrem Surg 14:173-77 CrossRef
11. Jacobsen K, Holst-Nielsen F (1977) A modified Mc Cash operation for Dupuytren’s contracture. Scand J Plast Reconstr Surg 11(3):231-33 CrossRef
12. Donaldson J, Goddar N (2012) The re-emergence of Percutaneous Fasciotomy in the Management of Dupuytren’s disease. Open Orthop J 6(Suppl 1: M10):83-7 CrossRef
13. Thomas A, Bayat A (2010) The emerging role of / Clostridium histolyticum collagenase in the treatment of Dupuytren disease. Therap Clin Risk Manag 6:557-72
14. Hurst LC, Badalamente MA, Hentz VR, Hotchkiss RN, Kaplan FT, Meals RA, Smith TM, Rodzvilla J, CORD I Study Group (2009) Injectable collagenase / Clostridium histolyticum for Dupuytren’s contracture. N Engl J Med 361(10):968-79 CrossRef
15. Gilpin D, Coleman S, Hall S, Houston A, Karrasch J, Jones N (2010) Injectable collagenase / Clostridium histolyticum: a new nonsurgical treatment for Dupuytren’s disease. J Hand Surg Am 35(12):2027-038 CrossRef
16. Peimer CA, Blazar P, Coleman S, Thomas F, Kaplan D, Smith T, Tursi JP, Cohen B, Kaufman GJ, Lindau T (2013) Dupuytren contracture relapse following treatment with collagenase / Clostridium histolyticum (CORDLESS Study): 3-year data. J Hand Surg 38(1):12-2 CrossRef
17. Foissac R, Camuzard O, Dumas P, Dumontier C, Chignon-Sicard B (2013) Treatment of Dupuytren’s contracture by collagenase injection. Chir Main 32(4):199-05 CrossRef
18. Witthaut J, Jones G, Skrepnik N, Kushner H, Houston A, Lindau TR (2013) Efficacy and safety of collagenase / Clostridium histolyticum injection for Dupuytren contracture: short-term results from 2 open-label studies. J Hand Surg Am 38(1):2-1- 作者单位：F. Alberton (1)
M. Corain (1)
A. Garofano (1)
L. Pangallo (1)
A. Valore (1)
V. Zanella (1)
R. Adani (1) (2)
1. Department of Hand Surgery, University Hospital of Verona, Policlinico GB Rossi, Piazzale LA Scuro 10, Verona, Italy
2. U.O.C. Chirurgia della Mano, Policlinico G.B. Rossi Azienda Ospedaliera Universitaria Integrata Verona, p.zzle L.A. Scuro, 10, Verona, Italy- ISSN：2035-5114
- 作者单位：F. Alberton (1)
文摘
Background Dupuytren’s disease (DD) is a fibroproliferative pathology that affects the palmar aponeurosis causing the development of nodules and collagen cords and the progressive flexion of the fingers. The standard procedure is surgical fasciectomy, followed by high recurrence rates. Collagenase Clostridium histolyticum (CCH) injection represents an innovative noninvasive approach to the treatment of DD. This prospective study was designed to examine the efficacy and safety of CCH injection performed in the outpatient, using local anesthesia. Materials and methods Forty patients [32 metacarpophalangeal (MP), 8 proximal interphalangeal (PIP)] with Dupuytren’s contracture of at least 20° for MP joint and any degree for PIP joint were included. The mean age was 66. All joints were treated with a single vial of collagenase injection and manual breaking of the cord 24?h after. All adverse effects (AEs) were monitored. Patients were checked 7, 30, 90, and 180?days after the injection. Primary endpoint was a reduction in digit contracture within 0°-° of normal extension. Secondary endpoints were the improvement of range of motion, the evaluation of AEs incidence, and cost-effectiveness of collagenase treatment. Results About 67.5?% of patients obtained a clinical success. At 6?months, a further 7.5?% attained the same result. The mean contracture of treated joints was 5.3o for MP and 6.8° for PIP joints. Twenty-three patients had one or more mild-to-moderate side effects. Conclusions The use of collagenase appears to be an effective and safe method for the treatment of Dupuytren’s contracture. Therapeutic success was achieved in a significant percentage of patients. The incidence of side effects was higher, but they were local reactions of short duration. The use of a single collagenase vial in patients treated in day surgery appears more cost-effective than surgery.