When we think of conditions that may affect the hands, we may imagine the aching pain of carpal tunnel syndrome or the stiffness of arthritis. Rarely do we look at the hands and say “Gee, I wonder if that is Dupuytren’s contracture!” It pays to know what this condition is, though, in the event you were to ever experience its symptoms.
What is Dupuytren’s Contracture?
This condition involves the progressive deformity of the hand caused by knotting in the superficial layer of tissue beneath the skin. This knotting continues and, over time, causes a thick cord to form. This cord then pulls on one or more fingers (usually the ring finger and pinky), causing them to bend. Eventually, the pull on affected fingers is great enough to inhibit the performance of normal activities because the fingers cannot be straightened. People with Dupuytren’s contracture may find it difficult to shake hands or to put their hands in their pockets.
The constant bend in the ring finger and pinky can be uncomfortable. It is important for individuals who experience this hand deformity to know that there are options for releasing fingers from the cord of knotted tissue.
Historically, Dupuytren’s contracture has been treated with specific hand surgery to remove the cord and straighten the fingers (once the cord is “cut” or removed, fingers naturally straighten). Surgery has typically been successful but comes with the drawback of a rather large incision and scar. Recently, an alternative has become available.
We are pleased to have the opportunity to help patients recover from Dupuytren’s contracture using Xiaflex. This injection treatment introduces collagenase clostridium histolyticum into the knotted tissue. This enzyme causes the cord to disintegrate naturally. We inject in three locations along the palpable cord and then apply a soft wrap to be worn for 24 hours. The next day, the cord should have broken apart enough for us to manually straighten the fingers. Even if a few strands of the cord have not fully broken, they are usually weak enough for us to “break” them without discomfort.
It is easy to find out if you are a good candidate for Xiaflex. Just schedule a visit to one of our New Jersey offices for a full consultation. After observing the extent of Dupuytren's contracture, we can discuss treatment options that can restore better mobility to your hand.