Treatment of Single Cords in Dupuytren Disease with Collagenase Clostridium Histolyticum: Study of a Cohort with Follow-up at 1 Year

Abstract

Objective The purpose of the present work was to assess the effectiveness of collagenase Clostridium histolyticum in patients with Dupuytren disease with single cords and assess the recurrence rate in the first year after the treatment. Material and Methods In this classic cohort study, a total of 53 patients (50 of them male) with a mean age of 68 years were studied who had been diagnosed with Dupuytren disease located in the metacarpophalangeal joint, in single cords, with more than 40° of extension loss. They were given an injection of collagenase C. histolyticum and later manipulation under locoregional anesthesia. The loss of extension was evaluated after a week and at the 1st, 3rd, 6th and 12th months. The effectiveness was analyzed with basis on the results of the Student t-test for paired data, as well as those of the effect size (ES) test. Results An important and statistically significant correlation was found for the loss of cord extension in the metacarpophalangeal joint (t = 32.113; p < 0.01; ES = 4.11; standardized response mean [SRM] = 4.15). Conclusion Collagenase is an injectable treatment, which is not very aggressive compared with surgery and is effective for the loss of extension in the metacarpophalangeal region secondary to single cord in Dupuytren disease during the first year.