Does collagenase injection disrupt or digest the Dupuytren’s cord: a magnetic resonance imaging study
| Autor: | Scott W. Wolfe, Schneider K. Rancy, Hollis G. Potter, K. M. Crivello, E. S. Moon |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pathology Cord Pilot Projects Injections Intralesional 030230 surgery Metacarpophalangeal Joint 03 medical and health sciences 0302 clinical medicine Collagenase clostridium histolyticum Clostridium histolyticum Humans Medicine Range of Motion Articular Dupuytren's contracture Aged 030222 orthopedics biology medicine.diagnostic_test business.industry Magnetic resonance imaging Middle Aged biology.organism_classification medicine.disease Magnetic Resonance Imaging Surgery Dupuytren Contracture Microbial Collagenase Treatment Outcome Microbial collagenase Collagenase Contracture medicine.symptom business Follow-Up Studies medicine.drug |
| Zdroj: | Journal of Hand Surgery (European Volume). 41:614-620 |
| ISSN: | 2043-6289 1753-1934 |
| DOI: | 10.1177/1753193415626113 |
| Popis: | Collagenase clostridium histolyticum has been extensively studied as a treatment modality for Dupuytren’s contracture. Its mechanism of action has been documented. It is unknown whether injected collagenase weakens the Dupuytren’s cord sufficiently to cause failure during manipulation or if there is digestion and reduction in cord volume. We examined five patients with isolated contractures of the ring or middle metacarpalphalangeal (MP) joint using magnetic resonance imaging (MRI) prior to injection with collagenase and again 1 month following injection. All patients had full correction after manipulation which was maintained at follow-up. The Dupuytren’s cord was evaluated with respect to volume, signal intensity, inflammatory changes and continuity. Additionally, signal intensity changes of the flexor tendons and neurovascular structures were recorded. MRI demonstrated cord discontinuity, significant reduction of cord volume and a significant increase in cord signal intensity after treatment with collagenase. There was a slight increase in flexor tendon signal intensity that was not significant. These findings suggest that there may be local chemical dissolution of the cord. Future studies may establish whether or not this will have prognostic implications in terms of correction and recurrence following collagenase injection. Level of evidence: IV |
| Databáze: | OpenAIRE |
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