Collagenase Clostridium histolyticum for the Treatment of Distal Interphalangeal Joint Contractures in Dupuytren Disease.

PURPOSE: To explore the efficacy of injectable collagenase Clostridium histolyticum (CCH) in distal interphalangeal (DIP) joint contractures in Dupuytren disease. METHODS: A retrospective review was conducted for patients with DIP joint contractures treated with CCH. Baseline contracture and posttreatment residual contracture were recorded. The primary end point was achievement of 0° to 5° of residual contracture 30 days postmanipulation. Recurrence and adverse events are also reported. RESULTS: Twenty-one patients were treated with collagenase for DIP joint contractures and had a mean follow-up of 2.6 months. Seventeen of 21 patients reached the primary end point of less than 5° residual flexion contracture. Eleven of 21 patients experienced an adverse event, most commonly bruising and edema. No serious complications such as neurovascular injuries or tendon ruptures were recorded. Two patients had recurrence of disease. CONCLUSIONS: Injection with CCH is an option for the treatment of DIP joint contractures in Dupuytren disease. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Experience with transtrapezium approach for transverse carpal ligament release in patients with coexisted trapeziometacarpal joint osteoarthritis and carpal tunnel syndrome.

An experience with transtrapezium approach for carpal tunnel release is reported. This technique seems to be successful in cases when carpal tunnel syndrome and first carpometacarpal joint osteoarthritis coexist and surgical treatment is indicated for both conditions. The transtrapezium approach to carpal tunnel release allows for complete carpal tunnel release without increasing the risk of surgical complications.

Percutaneous release of A1 pulley.

We performed 100 percutaneous releases of the trigger digits in a cadaveric model using an 18-gauge needle. Successful percutaneous release was achieved for only 59 digits (59%). No neurovascular injury occurred. We found that a percutaneous trigger digit release resulted in high percentage of incomplete releases of A1 pulley, especially in the thumb, index, and little fingers.

Recurrent enchondroma protuberans: a case report.

Enchondroma protuberans is a rare benign tumor. We present a case of late recurrence of a previously reported enchondroma protuberans in the hand. This was treated successfully with curettage and calcium carbonate grafting.

Giant cell tumour of the distal phalanx of the hand.

Giant cell tumour of bone in the phalanx of the hand is extremely rare. A case of giant cell tumour of distal phalanx treated with a ray amputation is presented.