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Evidence. Clarity. Practice.

© 2026 OrthoVellum. For educational purposes only.

Not medical advice. Verify clinically important information against current local guidance.

Back to Research
Level IHigh YieldHand & Upper LimbRandomised Controlled Trial

Evidence brief

Collagenase for Dupuytren's

Collagenase Clostridium Histolyticum for Dupuytren's Contracture

Authors
Hurst LC, Badalamente MA, Hentz VR, et al
Journal
N Engl J Med
Year
2009

Key Findings

  • 1

    Collagenase effective for cord rupture

  • 2

    64% achieved <5° contracture at MCP joint

  • 3

    CORD I and CORD II trials established efficacy

  • 4

    Recurrence rates higher than fasciectomy

  • 5

    Less invasive alternative to surgery

Clinical Implications

Collagenase injection offers a minimally invasive alternative to surgery for Dupuytren's contracture. Best for isolated MCP contractures with palpable cord.

Teaching Note

Know treatment options: observation, needle aponeurotomy, collagenase, fasciectomy, dermofasciectomy. Collagenase: MCP > PIP, single cord ideal. Recurrence higher than surgery. Complications: skin tear, tendon rupture. Fasciectomy remains gold standard for complex disease.

Citation

Hurst LC et al. Injectable collagenase clostridium histolyticum for Dupuytren's contracture. N Engl J Med. 2009;361(10):968-979.

PubMedDOI

Evidence Level

I

Level I

Systematic review of RCTs or high-quality RCT

Topics

DupuytrencollagenaseXiaflexRCTnon-surgical

Related Topics

  • Dupuytren Disease
  • Hand Contracture
  • Fasciectomy

External Links

View on PubMedView via DOI

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