{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:21:34Z","timestamp":1762899694441,"version":"3.40.5"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,1,26]],"date-time":"2019-01-26T00:00:00Z","timestamp":1548460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Dupuytren's disease causes a flexion contracture of the hand that limits hand function and reduces quality of life. Traditional management is surgical excision which is associated with potentially serious complications. A viable alternative is collagenase <jats:italic>Clostridium histolyticum<\/jats:italic> (CCH) (Xiaflex\u00ae; Pfizer Australia) which is an effective, safe, outpatient treatment that to date has no published data in the Australian public health setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort, single centre study, enrolling 54 patients to treat 81 joints with CCH. Patients received a single dose to the cord followed by joint manipulation 48\u2009h later. Primary endpoint was reduction in contracture to 0 to 5\u00b0 of full extension assessed 4 weeks after injection. Secondary endpoints included range of motion, patient satisfaction and function as measured by the Southampton Dupuytren's Scoring Scheme (SDSS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Primary endpoint was achieved in 48% of joints (66% metacarpophalangeal and 19% proximal interphalangeal). Mean flexion contracture improved by 40<jats:sup>o<\/jats:sup> and 25<jats:sup>o<\/jats:sup> for metacarpophalangeal and proximal interphalangeal joints, respectively. Mean active range of motion improved by 39<jats:sup>o<\/jats:sup> and 18<jats:sup>o<\/jats:sup>, respectively. At 30\u2009days and 12\u2009months, SDSS score demonstrated sustained improvement versus baseline (1.88 versus 8.24 <jats:italic>P<\/jats:italic>\u2009\u2264 0.0005 and 1.59 versus 8.07 <jats:italic>P<\/jats:italic> \u2264 0.0005). Sixty\u2010eight percent of patients were either very satisfied or satisfied at 12\u2010month follow\u2010up. Side effects of treatment were minor; with oedema and bruising the most common (87% and 85%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CCH injections are a viable treatment for Dupuytren's contracture in the Australian public health setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.14988","type":"journal-article","created":{"date-parts":[[2019,1,27]],"date-time":"2019-01-27T06:00:32Z","timestamp":1548568832000},"page":"573-577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Collagenase injections for Dupuytren's contracture: prospective cohort study in a public health setting"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9395-0344","authenticated-orcid":false,"given":"Jason","family":"Fletcher","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Gold Coast University Hospital  Southport Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ezekiel S. 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