COLLAGENASE IN THE TREATMENT OF DUPUYTREN'S DISEASE

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The aim of this study is to test the Phase 2 clinical efficacy of Clostridial collagenase as a non-operative (injectable) treatment for residual stage Dupuytren's disease. We propose to test whether Clostridial collagenase when infected into a pathological cord a. near the metacarpophalangeal join (MP), or b. near the proximalinterphalangeal joint (PIP) or c. near both the metacarpophalangeal joint (MP) and the proximalinterphalangeal joint (PIP) of residual stage Dupuytren's patients, will rupture the pathologic collagen cord upon active finger extension. A dose escalation scheme will be employed for cord rupture. Following cord rupture by collagenase, we will test if normal range of finger motion and normal grip strength is obtained and maintained in follow-up and that the disease will not recur with a frequency that is unacceptable based on the natural history of disease recurrence.