TY - JOUR
T1 - Outcomes of limited fasciectomy, needle fasciotomy and collagenase injection for Dupuytren's disease
T2 - a systematic review and meta-analysis of individual patient data
AU - van den Berge, Bente A
AU - Habibi, Hosniya
AU - Dijkstra, Pieter U
AU - Atroshi, Isam
AU - Davis, Tim Rc
AU - Jenmalm, Per
AU - van Rijssen, Annet
AU - Selles, Ruud W
AU - Scherman, Peter
AU - Strömberg, Joakim
AU - Skov, Simon T
AU - Vögelin, Esther
AU - Werker, Paul MN
AU - Broekstra, Dieuwke C
PY - 2025/5/20
Y1 - 2025/5/20
N2 - This systematic review and meta-analysis of individual patient data evaluates the outcomes of treatment for Dupuytren's disease using limited fasciectomy (LF), percutaneous needle fasciotomy (PNF) and collagenase clostridium histolyticum (CCH) injection. A total of 1423 studies were identified, of which 15 met the eligibility criteria for meta-analysis. The postoperative total extension deficit was smaller after LF than after PNF or CCH, but the difference was not clinically relevant. Minor complications were more frequent after CCH than after LF and PNF. The risk of major complications did not differ between the treatments. Recurrence occurred earlier after PNF and CCH than after LF during 36 months of follow-up. Patient-reported outcome measures showed substantial heterogeneity, which precluded meta-analysis. Overall, the clinically relevant contracture correction was comparable between LF, PNF and CCH, but CCH had a higher risk of minor complications and LF had the longest time to recurrence. Treatment decisions should consider the trade-off between complications and recurrence risk.
AB - This systematic review and meta-analysis of individual patient data evaluates the outcomes of treatment for Dupuytren's disease using limited fasciectomy (LF), percutaneous needle fasciotomy (PNF) and collagenase clostridium histolyticum (CCH) injection. A total of 1423 studies were identified, of which 15 met the eligibility criteria for meta-analysis. The postoperative total extension deficit was smaller after LF than after PNF or CCH, but the difference was not clinically relevant. Minor complications were more frequent after CCH than after LF and PNF. The risk of major complications did not differ between the treatments. Recurrence occurred earlier after PNF and CCH than after LF during 36 months of follow-up. Patient-reported outcome measures showed substantial heterogeneity, which precluded meta-analysis. Overall, the clinically relevant contracture correction was comparable between LF, PNF and CCH, but CCH had a higher risk of minor complications and LF had the longest time to recurrence. Treatment decisions should consider the trade-off between complications and recurrence risk.
U2 - 10.1177/17531934251338349
DO - 10.1177/17531934251338349
M3 - Review article
C2 - 40391547
SN - 0266-7681
JO - Journal of Hand Surgery (European Volume)
JF - Journal of Hand Surgery (European Volume)
ER -