Complications after treating Dupuytren's disease. A systematic literature review

Hand Surg Rehabil. 2017 Oct;36(5):322-329. doi: 10.1016/j.hansur.2017.07.002. Epub 2017 Sep 14.

Abstract

The objective of this study was to review the incidence of complications associated with different treatment options for patients with Dupuytren's disease. In a systematic literature review, the PubMed, EMBASE, Cochrane and Scopus databases were searched for clinical studies reporting complications after collagenase treatment, percutaneous needle fasciotomy (PNF), fasciectomy and dermofasciectomy. The incidence of complications was extracted from each study and stratified by procedure. From a total of 2251 references, 113 studies were analyzed and included with complication incidences varying from 0% to 100%. The highest number of nerve and vessel lesions were reported after fasciectomy, whereas the highest rate of edema was after collagenase injection. Accidental skin tears were mostly associated with collagenase and PNF treatment. Pooled complication incidences were 17.4% (95% CI: 11.7-23.1) for fasciectomy, 78.0% (95% CI: 59.6-96.4) for collagenase treatment, 18.9% (95% CI: -5.5-43.3) for PNF and 11.6% (95% CI: 0.0-23.2) for dermofasciectomy. Due to inconsistencies in reporting complications as well as the lack of a standardized definition, the literature does not provide evidence in favor of a specific procedure for Dupuytren's disease. A standardized definition of complications is required to improve the comparability of published results.

Keywords: Collagenase; Collagénase; Complication; Dermofasciectomie; Dermofasciectomy; Dupuytren's disease; Fasciectomie; Fasciectomy; Fasciotomie à l’aiguille percutanée; Maladie de Dupuytren; Percutaneous needle fasciotomy.

Publication types

  • Systematic Review

MeSH terms

  • Dupuytren Contracture / therapy*
  • Fasciotomy / adverse effects
  • Humans
  • Microbial Collagenase / administration & dosage
  • Microbial Collagenase / adverse effects
  • Needles
  • Orthopedic Procedures / adverse effects
  • Surgical Flaps / adverse effects

Substances

  • Microbial Collagenase