Background
The Royal Hobart Hospital has recently introduced Clostridium histolyticum collagenase injections (XiaflexÒ) as an alternative non-surgical pharmacological treatment of Dupuytren’s contractures.
Method
A retrospective analysis of outcomes in patients who underwent Xiaflex treatment for Dupuytren’s contracture at the Royal Hobart Hospital between May 2016 and October 2018.
Results
76 patients with Dupuytren’s contracture underwent Xiaflex treatment during this period. The mean age was 64 years of age. Of the 103 fingers which were treated Xiaflex, 82 fingers were for single joint contractures and 21 fingers involved multiple joint contractures. Mean follow-up was 4.3 months. A reduction in contracture to 0–5O of full extension was achieved in 46.1% of MCP joints treated, compared to 11.4% of PIP joints treated. Total flexion deformity improved by a mean of 30O. 85% of patients had Tubiana stage 1 disease post treatment compared to 43.7% pre-treatment. 8 out of 9 patients with Tubiana stage 3 disease had an improvement of disease staging. Minor complications included skin tears (40%) and bruising (1%). 7 patients re-developed contractures and required further Xiaflex treatment or fasciectomy (4.9% and 1.9% respectively).
Conclusion
Collagenase clostridium histolyticum injections are an effective and safe alternative treatment for Dupuytren’s contracture. However, it may be more successful in the treatment of MCP joint contractures.