Surgery for Dupuytren contracture demonstrates higher long-term success rate than needle, enzyme injection treatments

A randomized trial including 300 persons with Dupuytren contracture found that surgical intervention demonstrated better 2-year success rates compared with needle fasciotomy and collagenase injection. The study is published in Annals of Internal Medicine.

Dupuytren contracture is a common hereditary disorder characterized by an inability to fully extend 1 or more fingers and most often affects the ring and little fingers. It is caused by the gradual shortening of cords in the fascia of the palm. Dupuytren contracture related disability decreases when the finger contracture is released. Release can be achieved by surgery, needle fasciotomy, or collagenase injection.

Researchers from Kuopio University Hospital and Tampere University Hospital, Finland, conducted a multicenter, randomized, outcome assessor–blinded, superiority trial of 302 persons with Dupuytren contracture where 101 participants received a surgical intervention, 101 received a needle fasciotomy intervention, and 100 participants received collagenase injection. The authors found that success rates were similar at 3 months for all three interventions, but surgery had superior success rates compared with both needle fasciotomy and collagenase at two years. According to the authors, persons prioritizing long-term outcomes may choose surgery despite its early morbidity and higher cost. They note that collagenase is likely a viable alternative to needle fasciotomy only if its costs are substantially reduced.

Reference:

Mikko Petteri Räisänen, Olli V. Leppänen, Janne Soikkeli, Surgery, Needle Fasciotomy, or Collagenase Injection for Dupuytren Contracture A Randomized Controlled Trial, Annals of Internal Medicine, https://doi.org/10.7326/M23-1485.