3414 - Radiotherapy of Dupuytren's Contracture Following Collagenase Treatment

Purpose/Objective(s): Dupuytren’s contracture, a common fibroproliferative condition, frequently recurs after standard treatments, necessitating innovative approaches. The combination of collagenase injection followed by radiation therapy (RT) is a novel strategy to prevent recurrence, yet its efficacy remains underexplored. This study assesses outcomes in patients receiving this dual therapy.

Materials/Methods: A retrospective chart review evaluated 16 patients with Dupuytren’s contracture treated with collagenase (0.58 mg or 0.9 mg, based on severity) followed by RT (30 Gy in 10 fractions). Degrees of contracture were measured for CMC, MCP, and PIP joints across all fingers. Data included time between treatments, follow-up duration, prior treatments, and condition duration.

Results: The mean time between collagenase and RT was 96 days (SD 50.2), with an average follow-up of 310 days (SD 56.8). Seven patients had prior treatments (3 needle aponeurotomies, 4 surgeries), all with recurrence before undergoing collagenase and RT. Condition duration ranged: 2 patients (1-3 years), 4 (4-6 years), 4 (7-10 years), 6 (>10 years). The 4th finger MCP was most affected pre-treatment (50% prevalence, mean 17°), followed by the 5th finger MCP (50%, mean 12.8°) and 5th finger PIP (31.3%, mean 11.9°). No patients exhibited recurrence post-RT at follow-up. No patients experienced side effects of grade 2 or higher, the most common side effect being localized skin dryness.

Conclusion: This novel collagenase-RT combination achieved a 100% non-recurrence rate at follow-up, even in cases with significant pre-treatment contracture. These promising results suggest a highly effective option to maximize the durability of collagenase correction of Dupuytren’s contracture.