Three-Year Recurrence of Dupuytren Contracture after Needle Fasciotomy or Collagenase Injection: A Randomized Controlled Trial

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This single-center randomized controlled trial compared collagenase clostridium histolyticum (CCH) injections with percutaneous needle fasciotomy (PNF) for Dupuytren contracture affecting the metacarpophalangeal (MCP) joint alone. An independent observer assessed outcomes over three years. The analysis included 32 patients treated with CCH and 36 treated with PNF.<br /><br />Recurrence or disease progression requiring further treatment occurred in 6 patients (19%) in the CCH group, compared with 17 (47%) in the PNF group. The difference favored CCH and was statistically significant. Both treatments initially improved MCP extension, and patient-reported disability scores were generally low and similar. No serious adverse events, such as nerve or tendon injury or severe infection, were reported.<br /><br />The authors concluded that CCH was associated with less recurrence and progression than PNF at three years for isolated MCP contractures. Findings should be interpreted with some caution: the study did not reach its planned sample size and stopped enrollment after an interim analysis found a significant difference. Results apply specifically to isolated MCP contractures and may not extend to contractures involving other joints.

Keywords

Dupuytren contracture

collagenase clostridium histolyticum

percutaneous needle fasciotomy

metacarpophalangeal joint

randomized controlled trial

recurrence

disease progression

hand surgery

MCP extension

long-term outcomes