Trial Comparing Treatment Strategies in Dupuytren's Contracture (DETECT)
Dupuytren Contracture
About this trial
This is an interventional treatment trial for Dupuytren Contracture focused on measuring Hand, Xiapex, Xiaflex, Clostridium histolyticum collagenase, Needle, Surgery, Aponeurectomy, Aponeurotomy, Fasciotomy, Fasciectomy, Dupuytren's disease, Dupuytren's contracture, Contracture, Connective tissue disease
Eligibility Criteria
Inclusion Criteria:
- patients with ≥20° passive extension deficit (PED) in metacarpophalangeal (MP) or proximal interphalangeal (PIP) joint, or TPED of ≥30° in MP and PIP joints of finger/fingers II-V
- age > 18 years
- palpable cord
- provision of informed consent
- ability to fill the Finnish versions of questionnaires.
Exclusion Criteria:
- recurrent contracture in the finger to be treated
- neurologic condition causing the loss of function of the finger to be treated
- contraindication for collagenase clostridium histolyticym (Xiapex/Xiaflex ®)
- pregnant or breast feeding
- TPED > 135° (Tubiana stage 4) in finger to be treated
- rheumatoid arthritis
- previous fracture in finger to be treated, which affects range of motion of MP or PIP joint
- age > 80 years
Sites / Locations
- Central Hospital of Central Finland
- Tampere University Hospital
- Oulu University hospital
- Kuopio University hospital
- Helsinki University hospital
- Turku University Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
Percutaneous needle fasciotomy (PNF)
Collagenase clostridium histolyticum (CCH)
Limited fasciectomy (LF)
PNF is a treatment in which the Dupuytren's contracture cord causing the contracture is not excised, but only divided with a hypodermic needle.
Generic name of the drug is collagenase clostridium histolyticum. Dosage form is injectable powder, dosage 0.58 mg and frequency is one injection in four weeks up to three times. One injection is performed normally at least to three different places in the cord.
In LF, the thickened part of the palmar fascia causing the contracture is excised through skin incision.