DOS Kongressen 2014 ·
85
Xiapex® (collagenase clostridium histolyticum) –
treatment of patients with recurrence-Dupuytren’s
contracture – 1 year follow-up
Søren Larsen , Karina Liv Hansen, Tune Ipsen, Jens Lauritsen
Unit for Hand Surgery, Department of Orthopaedic Surgery, Odense University
Hospital
Background:
Dupuytren’s contracture (DC) is a disorder that affect the palmar
fascia where a pretendinous cord with time causes the finger to flex resulting in
impaired hand function.
Purpose / Aim of Study:
The aim of this study was to evaluate the efficacy
of Xiapex® treatment of recurrence- DC at least 12 month after Xiapex® injec-
tion.
Materials and Methods:
The study was a prospective study on consecutive
series of patients with recurrent DC and flexion deformities of the metacarpo-
phalangeal and/or proximal interphalangeal joint of >200 and a palpable cord.
Our end points was reduction in contracture, improving hand function and pa-
tient satisfaction
Findings / Results:
144 treatments were enrolled, 124 men and 20 women,
mean age 66 years [36-85]. 91% of the treated fingers are the 4. and 5. finger.
Treatment distribution MP/PIP joints were 45/55%. 49% had a skin-rupture
after manipulation and 89% of these patients had a need for additional visit
in our out-patient-clinic. Mean follow-up was 15 month [12-23]. At follow-
up a mean reduction in contracture of 60/30% for MP/PIP-joint. Mean DASH
pre-injection was 15 [0-61] and at 3 months follow-up 8 [0-39]. In 6 cases
(7%) there had been a need for further treatment of Xiapex® treated finger at
12 month (=unacceptable recurrence). At 12 months follow-up 44% of the
patients were satisfied or very satisfied.
Conclusions:
Our results are acceptable and we find Xiapex® a possible treat-
ment option for recurrence-DC-patients with a palpable cord. The treatment
is not as effective, has a higher recurrence-rate and lower patient satisfaction
compared to Xiapex® treatment of primary DC.
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