A Comparison of Percutaneous Needle Fasciotomy and Collagenase Injection for Dupuytren Disease

Purpose To compare percutaneous needle fasciotomy (PNF) with collagenase injection in the treatment of Dupuytren contracture. Methods A retrospective review was performed for patients with Dupuytren disease treated with PNF or collagenase. Range of motion, patient satisfaction, and complications were recorded. Results There were 29 patients in the collagenase group with mean baseline contractures of 40 degrees for 22 affected metacarpophalangeal joints and 50 degrees for 12 affected proximal interphalangeal joints. The PNF group was composed of 30 patients with mean baseline contractures of 37 degrees for 32 affected metacarpophalangeal joints and 41 degrees for 18 affected proximal interphalangeal joints. All patients were observed for a minimum of 3 months. Clinical success (reduction of contracture within 0 degrees to 5 degrees of normal) was accomplished in 35 of 50 joints (67%) in the PNF group and in 19 of 34 joints (56%) in the collagenase group. Patient satisfaction was similar between groups. Only minor complications were observed, including skin tears, ecchymosis, edema, pruritus, and lymphadenopathy. Conclusions In the short term, both PNF and collagenase have similar clinical outcomes and patient satisfaction. (J Hand Surg Am. 2013;38(12):2377-2380. Copyright (C) 2013 by the American Society for Surgery of the Hand. All rights reserved.)