Abe Yoshihiro
Department of Orthopedic Surgery, Chiba Rosai Hospital, Ichihara City, Japan.
J Hand Microsurg. 2020 Apr 13;14(2):113-120. doi: 10.1055/s-0040-1709097. eCollection 2022 Apr.
This study verified the effectiveness of oral prednisolone after collagenase clostridium histolyticum (CCH) (10 mg/day for 2 weeks) for Dupuytren's contracture with a 1-year follow-up. This study included 31 patients with a contracture of the metacarpophalangeal joint of ≥ 30 degrees. A total of 16 patients were allocated randomly to treatment with prednisolone and 15 patients were treated without prednisolone (control group). At day 7, mean total active motion (TAM) was 235 degrees in the prednisolone group and 228 degrees in the control group. Mean Visual Analog Scale was 3.3 in the prednisolone group and 4.6 in the control group. There was significant difference between two groups. At day 30, mean TAM was 241 degrees in the prednisolone group and 233 degrees in the control group. There were significant difference between two groups The mean QuickDASH score was significantly higher in the control group (5.8 vs. 3.4). Recurrence was observed in 2/16 patients (13%) in the prednisolone group and 5/15 patients (33%) in the control group; there was no significant difference. The administration of prednisolone decreased the likelihood of adverse effects, and also improved finger flexion range of motion and reduced pain after CCH.
本研究通过对接受溶组织梭状芽孢杆菌胶原酶(CCH)(10毫克/天,持续2周)治疗的掌腱膜挛缩患者进行为期1年的随访,验证了口服泼尼松龙的有效性。本研究纳入了31例掌指关节挛缩≥30度的患者。总共16例患者被随机分配接受泼尼松龙治疗,15例患者未接受泼尼松龙治疗(对照组)。在第7天,泼尼松龙组的平均总主动活动度(TAM)为235度,对照组为228度。泼尼松龙组的平均视觉模拟量表评分为3.3,对照组为4.6。两组之间存在显著差异。在第30天,泼尼松龙组的平均TAM为241度,对照组为233度。两组之间存在显著差异。对照组的平均QuickDASH评分显著更高(5.8对3.4)。泼尼松龙组16例患者中有2例(13%)出现复发,对照组15例患者中有5例(33%)出现复发;无显著差异。泼尼松龙的使用降低了不良反应的可能性,同时改善了CCH治疗后手指的屈曲活动范围并减轻了疼痛。