Assessing the Effect of Time From Injection of Collagenase to Manipulation on Success Rates in Dupuytren Disease

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Purushottam Nagarkar MD , Nirbhay S. Jain MD , Meaghan L. Barr MD , Cathy Tang MD , Dong Lee BS , Irene Chang BA , Michael R. Delong MD , Prosper Benhaim MD
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引用次数: 0

Abstract

Purpose

Dupuytren disease can be managed with an injection of collagenase Clostridium histolyticum enzyme followed by manual manipulation. Although the recommended time from injection to manipulation is 24–72 hours, patient and physician schedules may not accommodate this time frame. Therefore, we sought to study the impact of time from injection to manipulation on outcomes and complications of collagenase injection.

Methods

We performed a review of 309 patients who underwent an injection of collagenase Clostridium histolyticum for Dupuytren disease with manipulation at two, five, or seven days after injection. We compared preinjection and postinjection contracture angles as well as frequency of skin tears and tendon ruptures.

Results

Of the 309 patients, 207 underwent manipulation at two days, 32 at five days, and 70 at seven days. Patients had similar preinjection contracture angles. All patients demonstrated improvement in contracture after manipulation. Rates of skin tears and tendon ruptures were similar in all three groups. Significant predictors of complications included number of cords injected and history of previous collagenase injection, but not history of previous Dupuytren diagnosis.

Conclusions

Although collagenase injection for Dupuytren disease is typically performed with plans for manipulation at 24–72 hours, postinjection manipulation could be performed as late as seven days without adversely affecting the frequency of skin and tendon complications.

Type of study/level of evidence

Prognostic IV.
评估从注射胶原酶到操作时间对Dupuytren病成功率的影响。
目的:应用胶原酶溶组织梭菌酶注射液治疗双歧杆菌病,并辅以手法治疗。虽然从注射到操作的推荐时间是24-72小时,但患者和医生的时间表可能不适应这个时间框架。因此,我们试图研究从注射到操作的时间对胶原酶注射的结果和并发症的影响。方法:我们对309例接受胶原酶溶组织梭菌注射治疗Dupuytren病的患者进行了回顾,并在注射后2天、5天或7天进行了操作。我们比较了注射前和注射后的挛缩角度以及皮肤撕裂和肌腱断裂的频率。结果:在309例患者中,207例在第2天进行了操作,32例在第5天,70例在第7天。患者注射前挛缩角度相似。所有患者均表现出手法后挛缩的改善。三组的皮肤撕裂率和肌腱断裂率相似。并发症的重要预测因素包括注射脐带数量和既往胶原酶注射史,但不包括既往Dupuytren诊断史。结论:虽然胶原酶注射治疗Dupuytren病通常在24-72小时进行操作,但注射后操作可迟至7天进行,而不会对皮肤和肌腱并发症的频率产生不利影响。研究类型/证据水平:预后IV。
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
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