Dupuytren's contracture is a common hand problem that affects the palmar fascia. 
Several treatment options exist, but none are curative and recurrence is common. 
Bacterial collagenase has recently been proven beneficial for treating 
Dupuytren's disease, cleaving the collagen fibers at different sites, with 
weakening and eventually rupture of the fibrous cords after manipulation. An 
independent prospective follow-up study was organized on 87 patients, treated 
with one or more collagenase injections. Inclusion criteria were a contracture 
of at least 20° at the metacarpophalangeal (MCP) or the proximal interphalangeal 
(PIP) joint. The most diseased joint was taken into consideration for follow-up 
evaluation. The resulting extension deficit was measured at 1 month, 1 year and 
2 years and was graded as "clinical success", "clinical improvement" or 
"clinical failure". The mean contracture improved from 45° (39° for MCP and 54° 
for PIP joints) before treatment to 5° (2° for MCP and 9° for PIP joints) 
4 weeks after treatment. No serious complications occurred. After 2 years, 
68 joints were evaluated; 61.5% of the MCP joints and 34.5% of the PIP joints 
had a contracture of ≤20°. When compared with the 4-week evaluation, 28.2% of 
MCP joints and 62.1% of PIP joints had a recurrence (20° or greater worsening) 
or had received additional treatment. Collagenase injection is a safe and 
effective treatment option for Dupuytren disease, but recurrence is common 
especially for the PIP joint.