Treatment of Dupuytren's contracture: A systematic review

E. Soreide, Mohammad H Murad, J. M. Denbeigh, A. Dudakovic, Sanjeev Kakar, E. A. Lewallen, L. Nordsletten, Andre J van Wijnen

Research output: Contribution to journalReview article

6 Scopus citations

Abstract

Aims: Dupuytren's contracture is a benign, myoproliferative condition affecting the palmar fascia that results in progressive contractures of the fingers. Despite increased knowledge of the cellular and connective tissue changes involved, neither a cure nor an optimum form of treatment exists. The aim of this systematic review was to summarize the best available evidence on the management of this condition. Materials and Methods: A comprehensive database search for randomized controlled trials (RCTs) was performed until August 2017. We studied RCTs comparing open fasciectomy with percutaneous needle aponeurotomy (PNA), collagenase clostridium histolyticum (CCH) with placebo, and CCH with PNA, in addition to adjuvant treatments aiming to improve the outcome of open fasciectomy. A total of 20 studies, involving 1584 patients, were included. Results: PNA tended to provide higher patient satisfaction with fewer adverse events, but had a higher rate of recurrence compared with limited fasciectomy. Although efficacious, treatment with CCH had notable recurrence rates and a high rate of transient adverse events. Recent comparative studies have shown no difference in clinical outcome between patients treated with PNA and those treated with CCH. Conclusion: Currently there remains limited evidence to guide the management of patients with Dupuytren's contracture.

Original languageEnglish (US)
Pages (from-to)1138-1145
Number of pages8
JournalBone and Joint Journal
Volume100B
Issue number9
DOIs
StatePublished - Sep 1 2018

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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    Soreide, E., Murad, M. H., Denbeigh, J. M., Dudakovic, A., Kakar, S., Lewallen, E. A., Nordsletten, L., & van Wijnen, A. J. (2018). Treatment of Dupuytren's contracture: A systematic review. Bone and Joint Journal, 100B(9), 1138-1145. https://doi.org/10.1302/0301-620X.100B9.BJJ-2017-1194.R2