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. 2015 Dec 9;2015(12):CD010143. doi: 10.1002/14651858.CD010143.pub2

Degreef 2014.

Methods Single‐centre Belgian study
Randomised controlled clinical trial
Study period not stated
Participants 30 participants
26 male:4 female
Mean age: 63.5 (SD 8) years
Inclusion criteria: Adult patients scheduled for subtotal fasciectomy to treat Dupuytren's disease were eligible for inclusion if they had a D score > 4
Exclusion criteria: patients undergoing a reintervention for recurrent contractures; patients with a need for skin grafts or flaps; premenopausal women; patients using anti‐inflammatory drugs; patients with a history of malignancy; patients with a known allergy to tamoxifen
Interventions Segmental fasciectomy with 80 mg oral tamoxifen daily for 6 weeks before surgery continuing until 12 weeks after surgery
vs
Segmental fasciectomy with 80 mg oral placebo daily for 6 weeks before surgery continuing until 12 weeks after surgery
Outcomes
  • Improvement in extension deficit by joint

    • No differences at MCPJ at 3 months, 12 months or 24 months; significantly greater differences for tamoxifen group at PIPJ at 3 months and 12 months; not significantly different at 24 months

  • Tubiana index

    • Significantly greater differences in tamoxifen group at 3 months; not significantly different at 12 months nor 24 months

  • Satisfaction visual analogue scale

    • Significantly higher in tamoxifen group at 3 months; no significant differences at 12 months or 24 months

  • Hand function (DASH)

  • No significant differences at 12 months nor 24 months

Notes Length of follow‐up: 24 months
Low‐quality evidence, as inadequate details on study design and imprecision
Funding source: Belgian Orthopaedic Society
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Inadequate detail: not described
Allocation concealment (selection bias) Unclear risk Inadequate detail: boxes used to store allocation, but opacity not described; second copies of allocations stored in envelopes with inadequate details provided
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Attrition described; systematic differences between groups unlikely
Selective reporting (reporting bias) Unclear risk No data presented for hand function (DASH) at 3 months
Other bias Low risk Blinded study; hence blocked randomisation not problematic
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk Double‐blind
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Blinded outcome measurements