Collagenase in the treatment of Dupuytren's disease: an in vitro study.


Journal Article

The effects of clostridial collagenase on the tensile strength of Dupuytren's cords was studied in vitro to assess its potential efficacy as an agent for clinical enzymatic fasciotomy. Collagenase was injected into Dupuytren's cords from patients undergoing fascioctomy. Following a pilot experiment, in which a 3,600-unit dose of collagenase induced a 93% decrease in tensile modulus as compared with control cords, groups of five cords each were injected with 150, 300, and 600 units. These cords and a control group of five cords were tested by loading to failure in tension. The ultimate stress and strain to failure were recorded by a video capture technique. All specimens were stained for histologic examination with hematoxylin and eosin for collagen typing with sirrius red. Comparison of the ultimate stress values obtained with published values of extensor forces obtainable by the individual fingers of 40 normal hands indicated that a 300-unit dose of collagenase was sufficient for cord rupture within the average maximum force limits of the extensors of the index, long, ring, and small fingers (p < .02). All samples were in the residual disease stage histologically and contained type I collagen by sirrius red staining. These results indicate that collagenase may be effective in enzymatic fasciotomy of residual-stage Dupuytren's disease.

Full Text

Cited Authors

  • Starkweather, KD; Lattuga, S; Hurst, LC; Badalamente, MA; Guilak, F; Sampson, SP; Dowd, A; Wisch, D

Published Date

  • May 1996

Published In

Volume / Issue

  • 21 / 3

Start / End Page

  • 490 - 495

PubMed ID

  • 8724485

Pubmed Central ID

  • 8724485

Electronic International Standard Serial Number (EISSN)

  • 1531-6564

International Standard Serial Number (ISSN)

  • 0363-5023

Digital Object Identifier (DOI)

  • 10.1016/s0363-5023(96)80368-6


  • eng