Department of Orthopaedic Surgery, Hospital Universitario de La Ribera, Alzira, Valencia, Spain.
Department of Orthopaedic Surgery, Hospital Virgen de los Lirios, Alcoy, Alicante, Spain.
J Plast Surg Hand Surg. 2022 Feb;56(1):23-29. doi: 10.1080/2000656X.2021.1901723. Epub 2021 Apr 11.
The objective of this study was to compare the effectiveness of ultrasound-guided injection of collagenase Clostridium histolyticum (CCH) in patients with Dupuytren's contracture (DC), with the standard injection. We hypothesised that the ultrasound-guided Injection of CCH is more effective than the standard injection. A prospective cohorts study in patients with DC was done. We treated consecutively 47 fingers with the standard injection and 43 with the ultrasound-guided. Patients in both groups had the same inclusion criteria. The degrees of contracture of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints were measured before treatment and after three months. We compared the effectiveness of each type of injection in respect to obtaining a complete finger extension and to the percentage of improvement in each finger and in each joint. With ultrasound-guided injection, complete finger extension was obtained in 54% of cases and an 81% mean percentage of correction of the finger contracture; with standard injection 49% and 77%, respectively. In the MCP joint, the mean percentage of correction was 92.5 % in the ultrasound-guided Injection group and 84% in the standard injection group. In the PIP joint, it was 75.1% in the ultrasound-guided injection group and 65.3% in the standard injection group. These results showed no statistical significance. Hand surgeons must balance the possible benefits of the ultrasound-guided injection with the complexity and resources needed to perform the technique.
本研究的目的是比较超声引导下注射胶原酶 C. 组织梭菌（CCH）治疗掌腱膜挛缩症（DC）的效果与标准注射的效果。我们假设超声引导下注射 CCH 比标准注射更有效。这是一项针对 DC 患者的前瞻性队列研究。我们连续治疗了 47 根手指的标准注射和 43 根手指的超声引导注射。两组患者均符合相同的纳入标准。在治疗前和治疗后 3 个月，测量掌指关节（MCP）和近指间关节（PIP）的挛缩程度。我们比较了两种注射方法在获得完全手指伸展方面的有效性，以及在每个手指和每个关节的改善百分比。在超声引导注射组，54%的病例获得完全手指伸展，手指挛缩的平均矫正率为 81%；标准注射组分别为 49%和 77%。在 MCP 关节，超声引导注射组的平均矫正率为 92.5%，标准注射组为 84%。在 PIP 关节，超声引导注射组为 75.1%，标准注射组为 65.3%。这些结果没有统计学意义。手部外科医生必须权衡超声引导注射可能带来的好处与执行该技术所需的复杂性和资源。
