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Progressive Dupuytren contracture can be managed in three ways — surgery, needle fasciotomy, or collagenase injection. A 2024 randomized trial showed that surgery was superior to collagenase injections or needle fasciotomy after 2 years (NEJM JW Gen Med Mar 15 2024 and Ann Intern Med 2024; 177:280); however, some patients wish to avoid surgery. Now, a randomized U.K. trial has been conducted to compare collagenase injection with limited fasciectomy in 600 people with moderate Dupuytren contracture (i.e., discrete palpable collagen cord causing a ≥30-degree, but <130-degree, contracture of a metacarpophalangeal or proximal interphalangeal joint).
Mean baseline score on a validated hand-health questionnaire (range, 0–100, with higher scores wo…