Starkweather K D, Lattuga S, Hurst L C, Badalamente M A, Guilak F, Sampson S P, Dowd A, Wisch D
Department of Orthopaedics, Health Science Center, State University of New York at Stony Brook, NY, USA.
J Hand Surg Am. 1996 May;21(3):490-5. doi: 10.1016/S0363-5023(96)80368-6.
The effects of clostridial collagenase on the tensile strength of Dupuytren's cords was studied in vitro to assess its potential efficacy as an agent for clinical enzymatic fasciotomy. Collagenase was injected into Dupuytren's cords from patients undergoing fascioctomy. Following a pilot experiment, in which a 3,600-unit dose of collagenase induced a 93% decrease in tensile modulus as compared with control cords, groups of five cords each were injected with 150, 300, and 600 units. These cords and a control group of five cords were tested by loading to failure in tension. The ultimate stress and strain to failure were recorded by a video capture technique. All specimens were stained for histologic examination with hematoxylin and eosin for collagen typing with sirrius red. Comparison of the ultimate stress values obtained with published values of extensor forces obtainable by the individual fingers of 40 normal hands indicated that a 300-unit dose of collagenase was sufficient for cord rupture within the average maximum force limits of the extensors of the index, long, ring, and small fingers (p < .02). All samples were in the residual disease stage histologically and contained type I collagen by sirrius red staining. These results indicate that collagenase may be effective in enzymatic fasciotomy of residual-stage Dupuytren's disease.
研究了梭菌胶原酶对掌腱膜挛缩条索抗张强度的影响，以评估其作为临床酶性筋膜切开术药物的潜在疗效。将胶原酶注射到接受筋膜切除术患者的掌腱膜挛缩条索中。在一项预试验中，与对照条索相比，3600单位剂量的胶原酶使拉伸模量降低了93%，之后每组五条条索分别注射150、300和600单位胶原酶。对这些条索和一个由五条条索组成的对照组进行拉伸至断裂测试。通过视频捕捉技术记录极限应力和断裂应变。所有标本用苏木精和伊红染色进行组织学检查，用天狼星红进行胶原分型。将获得的极限应力值与40只正常手各手指可获得的伸肌力量的已发表值进行比较，结果表明，300单位剂量的胶原酶足以使示指、中指、环指和小指伸肌的平均最大力量范围内的条索断裂（p <.02）。所有样本在组织学上均处于残留疾病阶段，天狼星红染色显示含有I型胶原。这些结果表明，胶原酶可能对残留期掌腱膜挛缩症的酶性筋膜切开术有效。
