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1. Biochemistry and Mechanism of Action of Collagenase on Collagen
2. Collagenase: Preclinical Evaluation and Clinical Trials in the USA and Australia
3. The Normal Fibrous Skeleton of the Hand and Changes in Dupuytren’s Contracture
4. Collagenase in Europe from the Experimental Phase to Practical Use
5. Preparation, Injection and Traction Procedures (Pearls and Tips and Tricks): Technical Evolution and Results in Severe Cases
6. Dupuytren’s Disease of the Thumb and First Web
7. Rehabilitation After Treatment
8. Follow-up Studies, Satisfaction, Recurrence, Dosage and Drug Safety
9. American and European Regulations
10. Collagenase: Future Perspectives

This book offers detailed guidance on the use of collagenase, or enzymatic fasciotomy, as a nonsurgical treatment for Dupuytren’s contracture and explains its role in relation to the other forms of treatment, including open fasciectomy, needle aponeurotomy, and lipofilling. Clear guidance is provided on technique, current indications, and off-label usage. With the help of tips and tricks from leading experts, the reader will learn how to personalize the procedure to meet the needs of individual patients. Advice is also provided on all aspects of rehabilitation, which is a key determinant of treatment outcome. Collagenase treatment of Dupuytren’s disease has the benefits of low invasiveness and rapid patient recovery and achieves reasonable recurrence-free periods. It is especially valuable in patients with rapid recurrence following surgery. In documenting and appraising every aspect of its use, this book will be of value for all who treat patients with Dupuytren’s disease, including hand surgeons, orthopedists, plastic surgeons, physiatrists, and physiotherapists.

• Offers guidance on all aspects of the use of collagenase in patients with Dupuytren’s disease
• Explains how to personalize the procedure according to patient need
• Provides advice on optimization of rehabilitation
• Highlights useful tips and tricks

• Dr. Giorgio Eugenio Pajardi is Professor of Plastic and Reconstructive Surgery at Università degli Studi di Milano, Milan, Italy, where he is director of various courses on hand surgery and rehabilitation. While hand surgery is his principal field of interest, he is also a specialist in peripheral nerve surgery, neuro-orthopedic surgery, and reconstructive microsurgery. His mentors were in Italy Professor Ezio Morelli and outside Professor Guy Foucher, and Professor Pajardi adheres to the French School’s emphasis on hand surgery and hand rehabilitation as synergistic pillars of treatment. Professor Pajardi is the author of approximately 170 national and international publications and is a regular lecturer at national and international congresses. He is a member of the Italian Society of Plastic and Reconstructive Surgery, the Italian Society of Hand Surgery, and the International Federation of Hand Surgery Societies. He is also President of Centro Studi Mano, a cultural not for profit foundation whose statutory goal is to promote teaching and improve career pathways for young students.
• Dr. Marie Badalamente is Professor of Orthopaedics at Stony Brook University Medical Center, Stony Brook, New York, USA. She is the author of over 68 publications and 150 abstract/presentations. Along with Dr. Hurst, she is the inventor of collagenase clostridium histolyticum (CCH) in the treatment of Dupuytren disease through the Food and Drug Administration clinical trials process in the USA. As CCH is potentially a multi-use drug, Dr. Badalamente continues her research in it’s use for other medical indications, such as, adhesive capsulitis (frozen shoulder). Dr. Badalamente is a member of the American Society for Surgery of the Hand, American Acadmeny of Orthopaedic Surgeons and the Orthopaedic Research Society.
• Dr. Lawrence C. Hurst is Professor and Chairman of the Department of Orthopaedics, Chief of Hand Surgery, and Director of the Hand Fellowship Training Program at Stony Brook University Medical Center and CEO & Editor at Hand Surgery Resource, LLC.
Dr. Hurst is an active member of various professional societies, including the American Society for Surgery of the hand, the American Orthopaedic Association, the American Academy of Orthopaedic Surgeons, the Robert E. Carroll Hand Club, and the New York Society for Surgery of the Hand.
Dr. Hurst’s research interests include the safe and efficacious use of collagenase treatment in Dupuytren’s disease. He is widely published in peer-reviewed journals, such as Hand Surgery, Journal of Hand Surgery and the New England Journal of Medicine. He has authored numerous book chapters, including the chapter on Dupuytren’s disease in the 6th edition of Green's Operative Hand Surgery. He is Editor & Principle Author of, a web-based hand surgery teaching tool.
Dr. Hurst earned his medical degree at the University of Vermont College of Medicine and completed his residency in orthopaedic surgery at the University of North Carolina at Chapel Hill. He completed a fellowship in hand surgery at Columbia Presbyterian Medical Center and is board-certified by the American Board of Orthopaedic Surgery with a Certificate of Added Qualifications in Surgery of the Hand.