Keller M, Arora R, Schmiedle G, Kastenberger T
Department für Unfallchirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
Orthopade. 2017 Apr;46(4):321-327. doi: 10.1007/s00132-017-3386-6.
Dupuytren's disease as a benign fibroproliferative disease leads to hyperplasia of the collagen fibers of the fascia of the palm, which can result in severe impairment of the functionality of the hand.
Examination of the significance of non-operative treatment of Dupuytren's disease with injectable collagenase clostridium histolyticum (CCH) METHODS: Observation of 120 patients treated with injectable collagenase. Documentation of the range of motion before the intervention, 12 months after the intervention, and documentation of any adverse events.
All in all, 120 patients were treated (107 male, 13 female) (mean age 62 years, range 30-84 years). In 49% the little finger, in 44% the ring finger, in 4% the middle finger, and in 3% the index finger were treated. Full release was accomplished in 71%, partial release in 26%, and no change in 3% of the patients. The median contracture before the treatment was 37° for the metacarpophalangeal (MP) joint (range 25-100°) and 51° for the proximal interphalangeal (PIP) joint (range 30-97°). After 12 months, the mean contracture for the MP joint was 9° (range 0-25°) and 21° (range 10-36°) or the PIP joint. Adverse events occurred in 96% of patients within 3 months after treatment. No tendon ruptures, anaphylactic reactions, nerve, or ligament injuries were observed.
杜普伊特伦挛缩症作为一种良性纤维增生性疾病,会导致手掌筋膜胶原纤维增生,进而可能严重损害手部功能。
研究注射用溶组织梭菌胶原酶(CCH)非手术治疗杜普伊特伦挛缩症的意义。
观察120例接受注射用胶原酶治疗的患者。记录干预前、干预后12个月的活动范围,并记录任何不良事件。
总共治疗了120例患者(男性107例,女性13例)(平均年龄62岁,范围30 - 84岁)。治疗的手指中,小指占49%,无名指占44%,中指占4%,食指占3%。71%的患者实现了完全松解,26%的患者部分松解,3%的患者无变化。治疗前掌指(MP)关节的中位挛缩角度为37°(范围25 - 100°),近端指间(PIP)关节为51°(范围30 - 97°)。12个月后,MP关节的平均挛缩角度为9°(范围0 - 25°),PIP关节为21°(范围10 - 36°)。96%的患者在治疗后3个月内出现不良事件。未观察到肌腱断裂、过敏反应、神经或韧带损伤。