{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:17Z","timestamp":1787755577898,"version":"build-2784847793"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011594","name":"Sophies Minde Ortopedi","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011594","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100012446","name":"Akershus Universitetssykehus","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012446","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Collagenase\n                      <jats:italic toggle=\"yes\">Clostridium histolyticum<\/jats:italic>\n                      (CCH) and percutaneous needle fasciotomy (PNF) are 2 treatment options for Dupuytren disease. The purpose of this study was to compare these 2 methods in terms of clinical and patient-reported outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Eighty patients (median age, 72 years; 83% male) with a single-digit primary metacarpophalangeal (MCP) joint contracture of \u226530\u00b0 were randomized to either CCH or PNF and followed for 5 years. The primary outcome was the difference in flexion-contracture reduction at the MCP joint from baseline to 2 years, with additional analysis examining the effect of the primary endpoint variable up to 5 years. Secondary outcomes included complications, grip strength, scores on the visual analogue scale (VAS) for pain, the shortened version of the Disabilities of the Arm, Shoulder and Hand, the brief Michigan Hand Questionnaire, Unit\u00e9 Rhumatologique des Affections de la Main, and a VAS for treatment satisfaction as well as recurrence and retreatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean MCP joint contracture was 48\u00b0 at baseline and 2\u00b0 at 5 years in the CCH group, and 50\u00b0 at baseline and 7\u00b0 at 5 years in the PNF group. The reduction in MCP contracture at 2 years was larger in the CCH group than in the PNF group, with a mean difference between the groups of 12\u00b0 (95% confidence interval [CI], 1.5\u00b0 to 22.3\u00b0; p = 0.026). At 5 years, this mean difference was reduced to 6\u00b0 (\u22121.5\u00b0 to 12.8\u00b0; p = 0.1). There was no difference between the groups in any patient-reported outcome scores or grip strength beyond 4 weeks, with the exception of the brief Michigan Hand Questionnaire at 5 years. Ten (25%) of the patients in the PNF group compared with no patient in the CCH group had recurrence (contracture of \u226530\u00b0) at the MCP joint at 2 years. At 5 years, 17 (42.5%) of 40 patients in the PNF group had been retreated compared with 4 (10%) of 40 in the CCH group (p &lt; 0.001). The CCH group experienced more transient complications (stiffness and hematoma) during the first week and were more satisfied (VAS satisfaction) from 1 year to the 5-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The main finding of this study is that CCH and PNF were equally effective in reducing MCP flexion contracture, but the correction of contracture lasted longer in the CCH group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.24.00038","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T14:00:52Z","timestamp":1732111252000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Collagenase Clostridium histolyticum Versus Needle Fasciotomy for Primary Metacarpophalangeal Dupuytren Contracture"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2200-4662","authenticated-orcid":false,"given":"Ingi Thor","family":"Hauksson","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"Institute of Clinical Medicine, Campus Ahus, University of Oslo, L\u00f8renskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3555-5982","authenticated-orcid":false,"given":"Morten Beier","family":"Havdal","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4199-2272","authenticated-orcid":false,"given":"J\u016brat\u0117 \u0160altyt\u0117","family":"Benth","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Campus Ahus, University of Oslo, L\u00f8renskog, Norway"},{"name":"Health Services Research Unit, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9066-3689","authenticated-orcid":false,"given":"Sigurd E.","family":"Hoelsbrekken","sequence":"additional","affiliation":[{"name":"Department of Surgery, Volvat Medical Center, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7674-1572","authenticated-orcid":false,"given":"Per-Henrik","family":"Randsborg","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"Institute of Clinical Medicine, Campus Ahus, University of Oslo, L\u00f8renskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10]]},"reference":[{"issue":"9378","key":"R1-20250310","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/S0140-6736(03)13871-8","article-title":"Guillaume Dupuytren and finger contractures","volume":"362","author":"Gudmundsson","year":"2003","journal-title":"Lancet."},{"issue":"7","key":"R2-20250310","first-page":"695","article-title":"The prevalence of Dupuytren\u2019s disease in Norway. 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