Collagenase treatment of XXXX using a modified injection method.

@entity1 @entity8466 @entity281 @entity2074 @entity1159 @entity272
UNASSIGNED: Background and purpose - Treatment of @entity2074 ( @entity2074 ) with @entity8466 ( @entity8466 ) consists of injection followed by finger manipulation. We used a modified method, injecting a higher dose than recommended on the label into several parts of the cord, which allows treatment of @entity1159 in 1 session and may increase efficacy. We studied the occurrence of @entity272 and short-term outcome with this procedure. @entity1 and methods - We studied 164 consecutive hands with @entity2074 , palpable cord, and extension deficit of >=  20   in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint (mean @entity1 age 70 years, 82% @entity1 ). A hand surgeon injected all the content of 1 @entity8466 vial (approximately 0.80 mg) into multiple spots in the cord and performed finger extension under local anesthesia after 1 or 2 days. A nurse recorded @entity272 on a diagram and conducted a standard telephone follow-up within 4 weeks. A hand therapist measured joint @entity1159 before injection and at a median of 23 (IQR: 7-34) days after finger extension. Results - A skin tear occurred in 66 hands (40%). The largest diameter of the tear was  <= 5 mm in 30 hands and > 10 mm in 14 hands. Hands with skin tear had greater mean pretreatment MCP extension deficit than those without tear: 59   (SD 26) as opposed to 32   (SD 23). Skin tear occurred in 21 of 24 hands with MCP @entity1159 of >=  75  . All tears healed with open-wound treatment. No @entity281 occurred. Mean improvement in total (MCP + PIP) extension deficit was 55   (SD 28). Interpretation - Skin tears occurred in 40% of hands treated with collagenase injections, but only a fifth of them were larger than 1 cm. Tears were more likely in hands with severe @entity1159 . All tears healed without complications. Short-term @entity1159 reduction was good.
