Dupuytren's contracture (DC) is usually managed by conservative therapy, but can be treated with needling, enzyme injections or surgery, depending upon the severity. This study assessed the efficacy and safety of a modified treatment protocol using enzymatic injections for patients with DC.

This prospective cohort study included patients seen at one hospital with a diagnosis of DC between December of 2012 and November of 2013. All subjects had palpable cords with a restriction of range of motion of at least 20° in the metacarpophalangeal (MCP) joints and/or proximal interphalangeal joints. All were treated with collagenase clostridium histolyticum injections, with some receiving a larger than recommended dose. This treatment was followed by finger manipulation. Range of motion was measured before and after treatment.

Of the 164 hands treated, the mean baseline extension deficit was 79°. At a mean of 23 days after treatment, the mean change in the total extension deficit was 55°. Of those treated, 40% had skin tears, occurring more often among those with greater MCP extension deficits. At follow-up, all tears had healed. No other significant side effects were noted.

This study of patients with Dupuytren's contracture found that treatment with collagenase clostridium histolytica results in significant improvement in range of motion, although with a high prevalence of skin tears.