Odinsson Adalsteinn, Brenne Lars Erik, Lurie Tone Bøyesen, Finsen Vilhjalmur
1 Department of Orthopaedic Surgery, St. Olav's University Hospital, Trondheim.
2 Faculty of Medicine, Norwegian University of Science and Technology, Trondheim.
J Hand Surg Asian Pac Vol. 2016 Jun;21(2):187-92. doi: 10.1142/S242483551650017X.
Our main goal was to see if treatment with collagenase injection is safe and effective and to assess patient satisfaction with this new treatment.
We prospectively followed 77 consecutive patients, treated for contracture in 91 fingers and 142 joints that received total of 109 collagenase injections. The patients were reviewed on the first and second day and at 4 and 12 months. A contracture reduced to five degrees or less at 12 months after the last injection, was considered to be a successful outcome.
A mean of 1.2 injections were used per patient and 0.8 injections per joint. There was a significant improvement in mean passive extension deficit. Out of the 142 joints treated, 84 (59%) met our criterion for a successful outcome; 56 (80%) out of 70 MCP joints and 28 (39%) out of 72 PIP joints. There were also significant improvements in both hand function and pain. No serious adverse events were observed. The mean patient satisfaction with the treatment at the 12-month follow up was a VAS score of 78 (0 = none; 100 = complete) and only 11% stated that they would not have consented to the treatment if they had known the outcome in advance.
Treatment of Dupuytren's disease with collagenase injection is both safe and effective. It is now our primary treatment for Dupuytren's disease.
我们的主要目标是确定胶原酶注射治疗是否安全有效，并评估患者对这种新治疗方法的满意度。
我们前瞻性地跟踪了77例连续患者，他们因挛缩接受治疗，涉及91根手指和142个关节，共接受了109次胶原酶注射。在第一天、第二天、4个月和12个月时对患者进行复查。最后一次注射后12个月时挛缩减少至5度或更小被认为是成功的结果。
每位患者平均注射1.2次，每个关节平均注射0.8次。平均被动伸展缺陷有显著改善。在接受治疗的142个关节中，84个（59%）达到了我们的成功标准；70个掌指关节中有56个（80%），72个近端指间关节中有28个（39%）。手部功能和疼痛也有显著改善。未观察到严重不良事件。在12个月随访时，患者对治疗的平均满意度的视觉模拟评分（VAS）为78分（0分表示无；100分表示完全满意），只有11%的患者表示如果他们事先知道结果就不会同意接受治疗。
胶原酶注射治疗掌腱膜挛缩症既安全又有效。它现在是我们治疗掌腱膜挛缩症的主要方法。
