The Dupuytren’s contracture can be treated with three invasive methods, but new data from a randomized, controlled study show better 2-year success rates with surgical interventions compared to needle fasciotomy and collagenase injection despite repeat treatments.
The common hereditary disease affects the palmar fascia in middle-aged and older individuals, more commonly in men. Typically, the disease affects the ring finger and little finger, causing them to curve towards the palm. While the disease cannot be cured, it can be alleviated.
The results of the study, led by Dr. Mikko Petteri Räisänen of the Department of Orthopedics, Traumatology, and Hand Surgery at Kuopio University Hospital, Kuopio, and the University of Tampere, Tampere, both in Finland, were published online in the Annals of Internal Medicine.
Initially, in the multicenter, randomized, controlled, outcome evaluator-blinded superiority study, the results of the treatments were similar, but after two years, only the surgery group maintained the success rate.
After two years, the operation showed better success rates compared to needle fasciotomy and collagenase injection. The success rates of the surgery compared to needle fasciotomy were 78% vs. 50%, and compared to collagenase injection were 78% vs. 65%.
The study’s strength lies in its generalizability, as researchers recruited patients from a general healthcare context where only a few people seek treatment outside public hospitals.
Dr. Shannon Scott, DO, medical director of the Midwestern University Multispecialty Clinic in Scottsdale, Arizona, mentioned that in her practice, patients initially seek non-invasive options. However, the study’s results will help her guide patients when considering these options.
Dr. Dawn LaPorte, a hand surgeon at Johns Hopkins Medicine in Baltimore, Maryland, who was not involved in the study, noted that the study is significant, as it is the first to show long-term data with two-year results.
The conclusions of the study could change conversations between doctors and patients. Dr. LaPorte also discussed the advantages and disadvantages of different treatments, highlighting that collagenase injections are convenient but expensive, while needle fasciotomy and surgery have their own complexities.
In conclusion, the study provides valuable insights into the treatment of Dupuytren’s contracture, helping to inform medical decision-making and discussions between doctors and patients.