STUDY PROTOCOL Open Access
A feasibility study investigating the
acceptability and design of a multicentre
randomised controlled trial of needle
fasciotomy versus limited fasciectomy for
the treatment of Dupuytren’ s contractures
of the fingers (HAND-1): study protocol for
a randomised controlled trial
Eleanor Harrison
1
, Wei Tan
1
, Nicola Mills
2
, Alexia Karantana
3
, Kirsty Sprange
1
, Lelia Duley
1
, Daisy Elliott
2
,
Jane Blazeby
2
, William Hollingworth
2
, Alan A. Montgomery
1
and Tim Davis
4*
Abstract
Background: Dupuytren’s contractures are fibrous cords under the skin of the palm of the hand. The contractures
are painless but cause one or more fingers to curl into the palm, resulting in loss of function. Standard treatment
within the NHS is surgery to remove (fasciectomy) or divide (fasciotomy) the contractures, and the treatment
offered is frequently determined by surgeon preference. This study aims to determine the feasibility of conducting
a large, multicentre randomised controlled trial to assess the clinical and cost-effectiveness of needle fasciotomy
versus limited fasciectomy for the treatment of Dupuytren’s contracture.
Methods/design: HAND-1 is a parallel, two-arm, multicentre, randomised feasibility trial. Eligible patients aged
18 years or over who have one or more fingers with a Dupuytren’s contracture of more than 30° in the
metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joints, well-defined cord(s) causing contracture,
and have not undergone previous surgery for Dupuytren’s on the same hand will be randomised (1:1) to treatment
with either needle fasciotomy or limited fasciectomy. Participants will be followed-up for up to 6 months post
surgery. Feasibility outcomes include number of patients screened, consented and randomised, adherence with
treatment, completion of follow-up and identification of an appropriate patient-reported outcome measure (PROM)
to use as primary outcome for a main trial. Embedded qualitative research, incorporating a QuinteT Recruitment
Intervention, will focus on understanding and optimising the recruitment process, and exploring patients’
experiences of trial participation and the interventions.
Discussion: This study will assess whether a large multicentre trial comparing the clinical and cost-effectiveness of
needle fasciotomy and limited fasciectomy for the treatment of Dupuytren’s contractures is feasible, and if so will
provide data to inform its design and successful conduct.
(Continued on next page)
* Correspondence: Tim.Davis@nuh.nhs.uk
4
Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Derby
Road, Nottingham NG7 2UH, UK
Full list of author information is available at the end of the article
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Harrison et al. Trials (2017) 18:392
DOI 10.1186/s13063-017-2127-9