{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:15:50Z","timestamp":1788527750832,"version":"build-2803163510"},"reference-count":56,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Pers. Med.","JPM"],"abstract":"<jats:p>Background: Flexor tendon rupture is a rare but potentially disabling complication following minimally invasive treatment of Dupuytren\u2019s disease. This meta-analysis compared rupture incidence after collagenase Clostridium histolyticum (CCH) injection and percutaneous needle fasciotomy\/aponeurotomy (PNF\/PNA). Methods: PubMed, MEDLINE, and Embase were systematically searched for randomised trials, cohort studies, clinical trials, and case series reporting complications after CCH or PNF for Dupuytren\u2019s disease. Case reports and secondary evidence were excluded from incidence calculations, although reference lists of reviews were screened for eligible primary studies. Flexor tendon rupture events and study denominators were extracted as reported. Pooled incidence was estimated using random-effects proportional meta-analysis with logit transformation and continuity correction. Separate pooled estimates were generated for CCH and PNF, followed by subgroup comparison. Results: Forty-one studies were included. Across eligible studies, 68 flexor tendon ruptures were identified, including 62 after CCH and 6 after PNF. Ruptures most commonly involved the flexor digitorum profundus, affected the small finger, and occurred early, with a median time to rupture of 8 days, where reported. Fourteen PNF cohorts comprising 6058 treated units reported 6 ruptures, producing a pooled incidence of 0.32% (95% CI: 0.18\u20130.55%) with no observed heterogeneity. Twenty-nine CCH cohorts comprising 60,949 treated units reported 62 ruptures, producing a pooled incidence of 0.83% (95% CI: 0.42\u20131.64%) with substantial heterogeneity. Subgroup comparison demonstrated a higher pooled rupture incidence following CCH than PNF. Conclusions: Flexor tendon rupture is uncommon after both CCH and PNF. Characterisation of anatomical and treatment-related patterns of rupture may support more individualised risk counselling and treatment selection in Dupuytren\u2019s disease. Future studies are required to develop clinically meaningful risk-stratification strategies.<\/jats:p>","DOI":"10.3390\/jpm16090459","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:19:26Z","timestamp":1788232766000},"page":"459","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Flexor Tendon Rupture Following Collagenase Clostridium histolyticum Versus Percutaneous Needle Fasciotomy in the Management of Dupuytren\u2019s Disease: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0351-6352","authenticated-orcid":false,"given":"Sherlyn","family":"Chng","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, Melbourne 3199, Australia"},{"name":"Faculty of Medicine and Surgery, Peninsula Clinical School, Monash University, Frankston, Melbourne 3199, Australia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3471-8656","authenticated-orcid":false,"given":"Omar","family":"Shadid","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, Melbourne 3199, Australia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5444-8925","authenticated-orcid":false,"given":"Ishith","family":"Seth","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, Melbourne 3199, Australia"},{"name":"Faculty of Medicine and Surgery, Peninsula Clinical School, Monash University, Frankston, Melbourne 3199, Australia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4092-182X","authenticated-orcid":false,"given":"Warren M.","family":"Rozen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, Melbourne 3199, Australia"},{"name":"Faculty of Medicine and Surgery, Peninsula Clinical School, Monash University, Frankston, Melbourne 3199, Australia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jhsa.2021.07.005","article-title":"Dupuytren Contractures: An Update of Recent Literature","volume":"46","author":"Boe","year":"2021","journal-title":"J. Hand Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s12306-013-0304-x","article-title":"Efficacy and safety of collagenase Clostridium histolyticum injection for Dupuytren contracture: Report of 40 cases","volume":"98","author":"Alberton","year":"2013","journal-title":"Musculoskelet. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/17531934251360545","article-title":"Incidence of Dupuytren\u2019s disease following hand trauma","volume":"51","author":"Novo","year":"2026","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/01.prs.0000438455.37604.0f","article-title":"A Systematic Review and Meta-Analysis on the Prevalence of Dupuytren Disease in the General Population of Western Countries","volume":"133","author":"Lanting","year":"2014","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2340\/jphs.v60.42750","article-title":"Collagenase clostridium histolyticum for Dupuytren\u2019s disease: A comprehensive systematic review and comparative analysis against percutaneous needle aponeurotomy and limited fasciectomy","volume":"60","author":"Cevik","year":"2025","journal-title":"J. Plast. Surg. Hand Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jhsa.2012.10.008","article-title":"Efficacy and Safety of Collagenase Clostridium Histolyticum Injection for Dupuytren Contracture: Short-Term Results from 2 Open-Label Studies","volume":"38","author":"Witthaut","year":"2013","journal-title":"J. Hand Surg. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1080\/17453674.2020.1726057","article-title":"Percutaneous needle fasciotomy in Dupuytren contracture: A register-based, observational cohort study on complications in 3,331 treated fingers in 2,257 patients","volume":"91","author":"Therkelsen","year":"2020","journal-title":"Acta Orthop."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1056\/NEJMoa0810866","article-title":"Injectable Collagenase Clostridium Histolyticum for Dupuytren\u2019s Contracture","volume":"361","author":"Hurst","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Seth, I., McClure, V., Lim, B., Cuomo, R., Ross, R.J., and Rozen, W.M. (2025). Collagenase Clostridium Histolyticum Versus Percutaneous Needle Fasciotomy for Dupuytren\u2019s Disease: A Systematic Review and Meta-Analysis. Life, 15.","DOI":"10.3390\/life15020259"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.jhsa.2006.02.021","article-title":"A Comparison of the Direct Outcomes of Percutaneous Needle Fasciotomy and Limited Fasciectomy for Dupuytren\u2019s Disease: A 6-Week Follow-up Study","volume":"31","author":"Gerbrandy","year":"2006","journal-title":"J. Hand Surg. Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.jhsa.2017.03.003","article-title":"Injectable Collagenase Versus Percutaneous Needle Fasciotomy for Dupuytren Contracture in Proximal Interphalangeal Joints: A Randomized Controlled Trial","volume":"42","author":"Skov","year":"2017","journal-title":"J. Hand Surg. Am."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/j.jhsa.2016.06.014","article-title":"Comparison of Treatment Outcome After Collagenase and Needle Fasciotomy for Dupuytren Contracture: A Randomized, Single-Blinded, Clinical Trial With a 1-Year Follow-Up","volume":"41","year":"2016","journal-title":"J. Hand Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.2106\/JBJS.17.01128","article-title":"Percutaneous Needle Fasciotomy Versus Collagenase Treatment for Dupuytren Contracture","volume":"100","year":"2018","journal-title":"J. Bone Jt. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.hcl.2018.03.003","article-title":"Needle Aponeurotomy for Dupuytren Disease","volume":"34","author":"Elzinga","year":"2018","journal-title":"Hand Clin."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1177\/1753193414528843","article-title":"Safety and tolerability of collagenase Clostridium histolyticum and fasciectomy for Dupuytren\u2019s contracture","volume":"40","author":"Peimer","year":"2014","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1016\/j.jhsa.2015.04.036","article-title":"Dupuytren Contracture Recurrence Following Treatment With Collagenase Clostridium Histolyticum (CORDLESS [Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study]): 5-Year Data","volume":"40","author":"Peimer","year":"2015","journal-title":"J. Hand Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.jhsa.2012.01.029","article-title":"Results of Needle Aponeurotomy for Dupuytren Contracture in Over 1,000 Fingers","volume":"37","author":"Pess","year":"2012","journal-title":"J. Hand Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1097\/SAP.0b013e318264fd89","article-title":"The Use of Multiple Needle Fasciotomy in Dupuytren Disease","volume":"72","author":"Medjoub","year":"2014","journal-title":"Ann. Plast. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/j.jhsa.2011.05.016","article-title":"Flexor Tendon Rupture After Collagenase Injection for Dupuytren Contracture: Case Report","volume":"36","author":"Zhang","year":"2011","journal-title":"J. Hand Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jhsg.2022.08.013","article-title":"Incidence of Tendon Rupture After Collagenase Clostridium Histolyticum Injection for Treatment of Dupuytren Contracture in Adults: A Postmarketing Safety Analysis","volume":"5","author":"Peimer","year":"2022","journal-title":"J. Hand Surg. Glob. Online"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kolaski, K., Logan, L.R., and Ioannidis, J.P. (2023). Guidance to Best Tools and Practices for Systematic Reviews. JBJS Rev., 11.","DOI":"10.2106\/JBJS.RVW.23.00077"},{"key":"ref_22","first-page":"e24.00038","article-title":"Collagenase Clostridium histolyticum Versus Needle Fasciotomy for Primary Metacarpophalangeal Dupuytren Contracture: Five-Year Results from a Randomized Controlled Trial","volume":"9","author":"Hauksson","year":"2024","journal-title":"JB JS Open Access"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2377","DOI":"10.1016\/j.jhsa.2013.08.096","article-title":"A Comparison of Percutaneous Needle Fasciotomy and Collagenase Injection for Dupuytren Disease","volume":"38","author":"Nydick","year":"2013","journal-title":"J. Hand Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s11552-015-9740-4","article-title":"Modified Percutaneous Needle Aponeurotomy for the Treatment of Dupuytren\u2019s Contracture: Early Results and Complications","volume":"10","author":"Herrera","year":"2015","journal-title":"Hand"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1097\/PRS.0000000000003357","article-title":"Early Postoperative Results of Percutaneous Needle Fasciotomy in 451 Patients with Dupuytren Disease","volume":"139","author":"Molenkamp","year":"2017","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jpra.2020.11.008","article-title":"Versatility of Percutaneous Needle Fasciotomy for Dupuytren\u2019s Disease Across a Spectrum of Disease Severity: A Single-surgeon Experience of 118 Rays","volume":"27","author":"Patel","year":"2020","journal-title":"JPRAS Open"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e4604","DOI":"10.1097\/GOX.0000000000004604","article-title":"Dupuytren Disease: A Retrospective Cohort Study Comparing Collagenase Injection and Percutaneous Needle Fasciotomy","volume":"10","author":"Mehdiyev","year":"2022","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1177\/1753193411407245","article-title":"Percutaneous needle fasciotomy for primary Dupuytren\u2019s contracture","volume":"36","author":"Rahr","year":"2011","journal-title":"J. Hand Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1080\/2000656X.2019.1693391","article-title":"Needle Fasciotomy for Dupuytren\u2019s Contracture: A Prospective Cohort Study of 58 Fingers With a Median Follow-up of 6.5 Years","volume":"54","author":"Zachrisson","year":"2020","journal-title":"J. Plast. Surg. Hand Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s11552-012-9407-3","article-title":"Nonsurgical Treatment of Dupuytren\u2019s Contracture: 1-Year US Post-Marketing Safety Data for Collagenase Clostridium Histolyticum","volume":"7","author":"Peimer","year":"2012","journal-title":"Hand"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jhsa.2013.10.002","article-title":"Efficacy and Safety of Concurrent Collagenase Clostridium Histolyticum Injections for Multiple Dupuytren Contractures","volume":"39","author":"Coleman","year":"2014","journal-title":"J. Hand Surg. Am."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s11552-013-9524-7","article-title":"Examining the Efficacy and Maintenance of Contracture Correction after Collagenase Clostridium Histolyticum Treatment for Dupuytren\u2019s Disease","volume":"8","author":"McMahon","year":"2013","journal-title":"Hand"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1097\/PRS.0000000000002560","article-title":"Comparative Effectiveness of Percutaneous Needle Aponeurotomy and Limited Fasciectomy for Dupuytren\u2019s Contracture: A Multicenter Observational Study","volume":"138","author":"Zhou","year":"2016","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1016\/j.jhsa.2010.08.007","article-title":"Injectable Collagenase Clostridium Histolyticum: A New Nonsurgical Treatment for Dupuytren\u2019s Disease","volume":"35","author":"Gilpin","year":"2010","journal-title":"J. Hand Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1016\/j.jhsa.2014.07.010","article-title":"Prospective Randomized Controlled Trial Comparing 1- Versus 7-Day Manipulation Following Collagenase Injection for Dupuytren Contracture","volume":"39","author":"Mickelson","year":"2014","journal-title":"J. Hand Surg. Am."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1053\/jhsu.2000.6918","article-title":"Enzyme injection as nonsurgical treatment of Dupuytren\u2019s disease","volume":"25","author":"Badalamente","year":"2000","journal-title":"J. Hand Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1007\/s11552-013-9540-7","article-title":"Functional Outcome of Collagenase Injections Compared with Fasciectomy in Treatment of Dupuytren\u2019s Contracture","volume":"8","author":"Naam","year":"2013","journal-title":"Hand"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"472.e1","DOI":"10.1016\/j.jhsa.2017.03.001","article-title":"The Use of Residual Collagenase for Single Digits With Multiple-Joint Dupuytren Contractures","volume":"42","author":"Grandizio","year":"2017","journal-title":"J. Hand Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/SAP.0000000000001068","article-title":"Outcome of Dupuytren Contractures After Collagenase Clostridium Histolyticum Injection: A Single-institution Experience","volume":"79","author":"Hwee","year":"2017","journal-title":"Ann. Plast. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"782e","DOI":"10.1097\/PRS.0000000000005443","article-title":"Collagenase Clostridium Histolyticum for Dupuytren\u2019s Contracture: Comparing Single and Concurrent Injections","volume":"143","author":"Cook","year":"2019","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1016\/j.jhsa.2015.06.099","article-title":"The Efficacy and Safety of Concurrent Collagenase Clostridium Histolyticum Injections for 2 Dupuytren Contractures in the Same Hand: A Prospective, Multicenter Study","volume":"40","author":"Gaston","year":"2015","journal-title":"J. Hand Surg. Am."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s00064-015-0434-4","article-title":"Injectable collagenase Clostridium histolyticum as a nonsurgical treatment for Dupuytren\u2019s disease","volume":"28","author":"Arora","year":"2015","journal-title":"Oper. Orthop. Traumatol."},{"key":"ref_43","first-page":"397","article-title":"Effectiveness and safety of collagenase Clostridium histolyticum in Dupuytren\u2019s disease: An observational study in Belgium","volume":"82","author":"Verstreken","year":"2016","journal-title":"Acta. Orthop. Belg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e1275","DOI":"10.1097\/GOX.0000000000001275","article-title":"Difference in Success Treating PIP and MCP Joints with Collagenase","volume":"5","author":"Hansen","year":"2017","journal-title":"Plast. Reconstr. Surg. Glob. Open."},{"key":"ref_45","first-page":"859","article-title":"Factors influencing recurrence and progression of Dupuytren\u2019s disease treated by CCH","volume":"42","year":"2017","journal-title":"Int. Orthop."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1177\/1753193418790157","article-title":"Five-year results after collagenase treatment of Dupuytren disease","volume":"43","author":"Werlinrud","year":"2018","journal-title":"J. Hand Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1007\/s00402-019-03226-3","article-title":"Prospective observation of CCH for Dupuytren\u2019s disease: The Austrian register","volume":"139","author":"Rohit","year":"2019","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/PRS.0000000000001320","article-title":"CCH versus Limited Fasciectomy: Outcomes from a Propensity Score Matched Study","volume":"136","author":"Zhou","year":"2015","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Coleman, S., Gilpin, D., Tursi, J., Kaufman, G., Jones, N., and Cohen, B. (2012). Multiple concurrent CCH injections to Dupuytren\u2019s cords: An exploratory study. BMC Musculoskelet. Disord., 13.","DOI":"10.1186\/1471-2474-13-61"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/1753193416653249","article-title":"Efficacy and safety of CCH injection in non-Caucasian Japanese patients (CORD-J Study)","volume":"42","author":"Hirata","year":"2017","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s11845-014-1111-6","article-title":"Early results of the use of collagenase in the treatment of Dupuytren\u2019s contracture","volume":"184","author":"Considine","year":"2014","journal-title":"Ir. J. Med. Sci. (1971-)"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e629","DOI":"10.1097\/GOX.0000000000000565","article-title":"Collagenase Dupuytren Contracture: Achieving Single Treatment Success","volume":"4","author":"Malafa","year":"2016","journal-title":"Plast. Reconstr. Surg. Glob. Open."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1177\/1753193415617385","article-title":"One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren\u2019s contracture: A two-centre prospective randomized clinical trial","volume":"41","author":"Scherman","year":"2015","journal-title":"J. Hand Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.main.2014.01.006","article-title":"Traitement de la maladie de Dupuytren par collag\u00e9nase injectable, \u00e9valuation de l\u2019\u00e9chographie assist\u00e9e","volume":"33","author":"Mathys","year":"2014","journal-title":"Chir. Main."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3928\/01477447-20150504-03","article-title":"Ultrasound-Assisted Percutaneous Needle Fasciotomy for Dupuytren\u2019s Contracture","volume":"38","author":"Sakellariou","year":"2015","journal-title":"Orthopedics"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1080\/2000656X.2021.1901723","article-title":"Can collagenase effectiveness in Dupuytren\u2019s contracture be improved by using ultrasound-guided Injection? A comparative study","volume":"56","author":"Aguilella","year":"2021","journal-title":"J. Plast. Surg. Hand Surg."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/9\/459\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T12:32:26Z","timestamp":1788525146000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/9\/459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":56,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jpm16090459"],"URL":"https:\/\/doi.org\/10.3390\/jpm16090459","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]}}}