Unusual Intranodular Collagenase Injection: A Case of Bilateral Ledderhose Disease

Summary: Ledderhose disease (LD) is a rare plantar fibromatosis of the foot, frequently associated with Dupuytren disease. Collagenase of Clostridium hystoliticum has recently revolutionized the way to treat Dupuytren disease. Nevertheless, the literature is still critically lacking about the use of collagenase injection in LD. We report a case of a man with bilateral symptomatic LD treated with collagenase. Injections (0.58 mg of collagenase of C. hystoliticum) were performed into nodules. Forced extension after injection was not performed. The patient could walk normally immediately after procedure. The procedure was a complete success without side effects or complications on either foot. Currently, at 14 months after treatment of the right foot and 12 months after treatment of the left foot, no recurrence has been observed. Collagenase injection was only effective in treating symptomatic LD in this one patient we reported on.