Traitement des brides de la maladie de Dupuytren par la collagénase injectable

Dupuytren's disease is a disorder of the palmar aponeurosis responsible for apparition of pathological collagen cords that will gradually lead to a digital retraction. These cords cause functional disability to the hand with a real handicap for the patient. No curative treatment exists currently in this disease. Injections of collagenase from Clostridium histolyticum cause lysis of the collagen present in the cords and cause an interruption of the palmar cord. It is a new treatment in the management of Dupuytren's disease. The use of collagenase injection in the treatment of palmar form of Dupuytren's disease gives good results in the short and medium terms. It is a simple, minimally invasive treatment, several studies have proven its effectiveness and it approximates percutaneous needle fasciotomy in its easy use and its indications. Patients should be well informed about local reactions and transient pain with the injection of C. histolyticum collagenase. Diffusion of this technique is still limited by: the assessment of its cost compared to that of other methods of treatment and particularly the needle fasciotomy, and the evaluation of results over the long-term.