Dupuytren’s contracture is a condition in which one or more fingers curl in toward the palm. The victim may be completely unable to open the hand and this can eventually lead to a permanent disability. The usual treatment is surgery and extensive post-surgical hand therapy. Even with this, however, the condition may recur.
A study in The New England Journal of Medicine suggests that there may be a different way to treat this problem. The investigators injected an enzyme that breaks down collagen in the affected finger. The lead author describes the treatment as an enzymatic knife that weakens the toughened tissue that has caused the contracture. In the study, the enzyme worked for nearly two thirds of the fingers treated. The placebo only worked for 9 percent. There were side effects, such as pain at the injection site, swelling and bruising. Nevertheless, this approach represents a whole new way to treat Dupuytren’s contracture. If it holds up, the enzyme may be tested in other fibrotic conditions such as frozen shoulder syndrome and Peyronie’s disease in which the penis bends to the side.
[New England Journal of Medicine, Sept. 3, 2009]