Clinical trial · Interventional

Trial Comparing Treatment Strategies in Dupuytren's Contracture

DupuytrEn Treatment EffeCtiveness Trial (DETECT): Needle Fasciotomy, Surgery or Collagenase Injection for Dupuytren's Contracture

NCT03192020CI-TRIAL-00109809DETECTactive not recruitingPhase 4ClinicalTrials.gov clinicaltrialsPublishedExplore in graph →

Summary

Brief summary (as posted)

Trial is a prospective, randomized, controlled, outcome assessor-blinded, three armed parallel 1:1:1, multicenter trial. The research objective is to determine, which treatment strategy 1) primary percutaneous needle fasciotomy (PNF) followed by surgical limited fasciectomy (LF) in patients who do not respond to PNF, 2) primary collagenase clostridium histolyticym (CCH) followed by LF in patients who do not respond to CCH or 3) LF as the primary (and secondary) treatment modality is the most cost-effective in treating Dupuytren´s contracture. Short- and long-term results will be published.

Conditions

Conditions (1)

Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.

Condition (as posted)	Mapped entity	Match	Confidence
Dupuytren Contracture	Palmar Fibromatosis	ALIAS	0.90

Interventions

Interventions (3)

Intervention	Type	Mapped drug	Match
Collagenase Clostridium Histolyticum (CCH) 2.9 MG/ML [Xiaflex]	Drug	—	UNRESOLVED
Limited fasciectomy (LF)	Procedure	—	UNRESOLVED
Percutaneous needle fasciotomy (PNF)	Procedure	—	UNRESOLVED

Design

Arms and outcomes

Arms (3)

type
EXPERIMENTAL
label
Percutaneous needle fasciotomy (PNF)
description
PNF is a treatment in which the Dupuytren's contracture cord causing the contracture is not excised, but only divided with a hypodermic needle.
interventionNames
1. Procedure: Percutaneous needle fasciotomy (PNF)
2. Procedure: Limited fasciectomy (LF)
type
EXPERIMENTAL
label
Collagenase clostridium histolyticum (CCH)
description
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.
interventionNames
1. Drug: Collagenase Clostridium Histolyticum (CCH) 2.9 MG/ML [Xiaflex]
2. Procedure: Limited fasciectomy (LF)

Eligibility

Eligibility (as posted)

Sex: All
Minimum age: 18 Years
Maximum age: 80 Years

Show eligibility criteria text

Inclusion Criteria:

* patients with ≥20° passive extension deficit in metacarpophalangeal (MPJ) or proximal interphalangeal joint (PIPJ), or TPED ≥30° in MPJ and PIPJ 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
* total passive extension deficit \> 135° (Tubiana stage 4) in finger to be treated
* rheumatoid arthritis
* previous fracture in finger to be treated, which affects range of motion of MPJ or PIPJ
* age \> 80 years

References

Publications (3)

BACKGROUNDRaisanen MP, Karjalainen T, Goransson H, Reito A, Kautiainen H, Malmivaara A, Leppanen OV. DupuytrEn Treatment EffeCtiveness Trial (DETECT): a protocol for prospective, randomised, controlled, outcome assessor-blinded, three-armed parallel 1:1:1, multicentre trial comparing the effectiveness and cost of collagenase clostridium histolyticum, percutaneous needle fasciotomy and limited fasciectomy as short-term and long-term treatment strategies in Dupuytren's contracture. BMJ Open. 2018 Mar 28;8(3):e019054. doi: 10.1136/bmjopen-2017-019054. PMID 29599391
RESULTRaisanen MP, Leppanen OV, Soikkeli J, Reito A, Malmivaara A, Buchbinder R, Kautiainen H, Kaivorinne A, Stjernberg-Salmela S, Lappalainen M, Luokkala T, Ponkko A, Taskinen HS, Paakkonen M, Jaatinen K, Juurakko J, Karjalainen VL, Karjalainen T. Surgery, Needle Fasciotomy, or Collagenase Injection for Dupuytren Contracture : A Randomized Controlled Trial. Ann Intern Med. 2024 Mar;177(3):280-290. doi: 10.7326/M23-1485. Epub 2024 Feb 13. PMID 38346307
DERIVEDKarjalainen VL, Soikkeli J, Raisanen MP, Leppanen OV, Reito A, Stjernberg-Salmela S, Buchbinder R, Karjalainen T. Progression of Dupuytren Contracture: A Randomized Controlled Trial Comparing Surgery, Needle Fasciotomy, and Collagenase Injection. Plast Reconstr Surg. 2026 Jul 1;158(1):101-112. doi: 10.1097/PRS.0000000000012666. Epub 2025 Dec 4. PMID 41334972

Registry

Dates and enrollment

Start: Sep 15, 2017
Primary completion: May 31, 2026
Completion: May 31, 2031
First posted: Jun 19, 2017
Last update posted: Apr 29, 2026
Enrollment: 302 (actual)
Lead sponsor: Tampere University OTHER
Collaborators: Central Finland Hospital District; Helsinki University Central Hospital; Turku University Hospital; Tampere University Hospital; Kuopio University Hospital; Oulu University Hospital; Medcare Oy; Finnish Institute for Health and Welfare; Orton Orthopaedic Hospital
Keywords: Hand, Xiapex, Xiaflex, Clostridium histolyticum collagenase, Needle, Surgery, Aponeurectomy, Aponeurotomy, Fasciotomy, Fasciectomy, Dupuytren's disease, Dupuytren's contracture, Contracture, Connective tissue disease

Data updated 22 days agoSource updated Apr 29, 2026source: clinicaltrials

Locations

Locations by country (6)

Country	Sites	Recruiting
Finland	6	0

Trial listing is informational. Eligibility is decided by the study team; contact information is on ClinicalTrials.gov.