From: Systematic review of non-surgical treatments for early Dupuytren’s disease
Author (year) treatment | Total cohort of DD patients (hands) | Number of patients (hands) with early DD | Study type | Level of evidence (OCEBM) Prospective (P) Retrospective (R) Not stated (N) | Outcome measure | Results | Recurrence | Adverse events | ||
---|---|---|---|---|---|---|---|---|---|---|
Improved | No change | Deteriorated | ||||||||
Steroids | ||||||||||
Baxter (1952) [30], Intramuscular | 11 (16) | 1 (2) | Case study | 5 (N) | Clinical observation of nodules, extension deficit | 0 | 1 | 0 | Not reported | Not reported |
Oral | 1 (2) | Case study | 5 (N) | Clinical observation of palmar fascia | 0 | 1 | 0 | Not reported | Not reported | |
Ketchum (2000) [31], Injection | 63 (75) | 63 (75) | Case series | 4 (N) | Nodule easier to inject and flatter | 62 patients (73 hands) | 0 | 1 patient (2 hands) | 50 % of patients at 1 to 3 years | 50 % patients reported transient depigmentation or temporary subcutaneous atrophy at injection site. ‘Nearly all’ resolved at 6 months |
Clinically observed digital contracture | 0 | 62 patients (73 hands) | 1 patient (2 hands) | |||||||
Shelley (1993) [32], Topical | 2 | 1 | Case study | 5 (N) | Contracture shrinkage | 1 | 0 | 0 | None at 2 years | Not reported |
Zachariae (1955) [33], Injection | 11 (11) | 9 (9) | Case series | 4 (N) | Fibrosis diminished or softer | 9 | 0 | 0 | 1 at 14 months | Not reported |
Coste (1953) [34], Injection | 9 (13) | 2 (2) | Case series | 4 (N) | Clinical observation of nodules, extension deficit | 2 | 0 | 0 | Not reported | Not reported |
Vitamin E (oral) | ||||||||||
Reilly (1974) [35] | 1 (2 hands) | 1 (2 hands) | Case study | 5 (N) | Clinical observation | 0 | 0 | 1 patient (2 hands) | Eventually required surgery in both hands | Not reported |
Richards (1952) [36] | 70 hands | 63 hands | Case series | 4 (N) | Observation, deformity monitored using plaster cast moulds | 0 | 60 | 3 | Not reported | No toxic effects |
Steinberg (1951) [18] | 22 | 6 | Case series | 4 (N) | Clinical observation | 6 | 0 | 0 | Not reported | Not reported |
Other | ||||||||||
Skliarenko (1982) [37], furazolidone injection | 98 | 74 | Case series | 4 (N) | Clinically observed digital contracture | 74 | 0 | 0 | 9 patients in total cohort (4 at 1 year, 3 at 2 years, 2 after 3 years) | 18 of total cohort of 98 reported minor hand swelling, raised temperature after 1st injection. No systemic side effects. |
Gatev (1997) [38], Topical aminosyn and ultrasound | 63 | 22 | Cohort study | 4 (N) | Clinical observation of palm thickening, tension and trembling | 21 | 1 | 0 | Not reported | Not reported |
Topical aminosyn | 4 | 4 | 0 | 0 | ||||||
Ultrasound | 6 | 4 | 2 | 0 | ||||||
Yildiz (2004) [39], Hyperbaric oxygen | 1 | 1 | Case study | 5 (N) | Extension deficit, clinical observation | 1 | 0 | 0 | None at 1 year | No adverse effects. |