The orthopedic surgeons at Advanced Orthopedics and Hand Surgery are able to offer Xiaflex Treatment in Wayne and Clifton, NJ
What Is Dupuytren's Contracture (Viking's Disease)?
Dupuytren's contracture is named after the surgeon, Baron Guillaume Dupuytren, who recorded how to operate on the condition in 1831. It is also known as the Vikings Disease because it mainly affects men of northern European ancestry. Dupuytren's contracture is caused by nodules of tissue in the palm and fingers developing into thickened cords. Dr. Peter Denoble and Dr. Ghobadi have years of experience dealing with both surgery and treatment for Dupuytren's contracture.
Viking's Disease Causes & Symptoms
Why they form is unknown, but as they thicken, they begin to tether the fingers into a fixed, flexed position. Most commonly, it is the ring and/or pinky fingers that tend to bend toward the palm and cannot be straightened. The onset of Dupuytren’s is usually gradual and painless, but it can limit one's ability to use their hand. This may limit their ability to grasp a jar or even just clap his or her hands.
The causes of this mysterious condition are unknown, but there are certain risk factors such as:
- Age — Dupuytren’s contracture occurs usually after the age of 50.
- Sex — Men are more commonly afflicted and it is more severe.
- Ancestry — People of Northern European descent are at higher risk, hence the colloquial name for the disease, Viking’s Disease.
- Family history — This disease runs in families.
- Smoking and drinking — There is some evidence of an increased risk in smokers and heavy drinkers.
- Diabetes — Diabetes increases the risk.
Xiaflex Surgical Treatment
Xiaflex is an enzyme called collagenase clostridium histolyticum. On the first day of treatment, we inject it into several spots along the cord. Next, we then place your hand in a soft hand wrap. 24 hours later you will return to the office for cord rupture. At this point, the enzyme has dissolved a majority of the cord. The doctor will then gently straighten the finger and tear any remaining cord fibers that remain (this is typically painless).
Depending on the severity of the contracture you may be at risk for skin tears which are usually minor and heal over the next couple weeks. We may also use night splinting for several weeks after manipulation of the cord. We intend the treatment to be a permanent solution to the contracture, although there is always a chance for new cords to develop or reform. The enzyme injection is a great treatment option for patients who want to avoid surgery and have a quick return to function.
Am I a Candidate for Xiaflex Treatment?
Xiaflex is only available upon the recommendation of your hand surgeon, by prescription only, so make an appointment today to see if you qualify. Experienced hand surgeons like Dr. Ghobadi and Dr. DeNoble have used Xiaflex with dramatic and satisfying results and would like you to benefit from this wonderful new treatment option.
"Dr. DeNoble has a rare knack for making his patients feel right at home in his office. He took the time and patience to answer any and all questions I had. I came to him from the hospital after an accident with four broken fingers. I was in great pain and he knew right away I needed to be operated on to save my hand that was turning black. He operated on me immediately at the hospital and my hand was saved. I have almost full use of it now. I would highly recommend him and his staff."
"Dr. DeNoble operated on my Achilles Tendon in October, 2012. I would like to express my gratitude on what a fantastic job he did. His caring and professionalism were outstanding. I mention his name to all who ask me about my injury, and I tell them I would not go to any other doctor. Thank you again for your help."
Diagnosing Dupuytren’s Contracture
In most cases, Dr. Ghobadi or Dr. DeNoble can diagnose Dupuytren’s simply by the look and feel of your hands. They can compare hands and check for puckering on the skin of your palms. By pressing on parts of your palms and fingers, they can check for the toughened knots or bands of tissue. Another sign is to have you put your hand flat on the table. If you can’t fully flatten your fingers it is a sign of Dupuytren’s.
Is Xiaflex The Only Treatment For Dupuytren's Contracture?
Previously, the most common treatment involved removing the affected fibrous tissue surgically through large zig-zag incisions on the palm and finger, which comparatively resulted in longer recovery times, more scarring, and increased risk of nerve injury.
Do Xiaflex Injections Hurt?
Prior to injecting the Xiaflex, we inject lidocaine into numerous locations on your hand. Still, if your Dupuytren’s contracture is causing pain prior to treatment, you will likely have more pain during injection and breaking of the cords. You won’t feel anything with the injections, due to the lidocaine, but some patients experience a throbbing pain within a couple hours of the injections. This may require prescription pain medication, which we will make available to you. The degree of pain varies dramatically between patients, but it is something to be aware of going into Xiaflex treatment for Dupuytren’s.
What To Expect After The Xiaflex Treatment
Xiaflex is the only FDA-approved nonsurgical treatment for Dupuytren’s contracture. These injections have good rates of success where patients can achieve either full range of motion or vastly improved range of motion. Success rates from Xiaflex research range from around 50-65 percent improvements in range of motion after three injections of Xiaflex. The results are difficult to compare because different patients develop the knots and bands in different degrees.
Still, Xiaflex, combined with a finger extension/manipulation to break the remaining bands, can straighten your hand and return a usable range of motion. Since 2010, it is estimated that over 100,000 patients have been treated with Xiaflex.
How Much Does Xiaflex Cost?
Xiaflex is not inexpensive. How much you pay will depend on your health benefits or insurance coverage. The manufacturer of Xiaflex does offer a Xiaflex Copay Assistance Program.
Schedule a Consultation
Dr. Ghobadi and Dr. DeNoble, the hand surgeons of Advanced Orthopedics and Hand Surgery Institute in Wayne, NJ, perform Xiaflex injections, the exciting new non-operative treatment for Dupuytren’s contracture. Xiaflex is the only US Food and Drug Administration (FDA) approved injectable treatment for Dupuytren’s contracture.
Contact Advanced Orthopedics & Hand Surgery Institute for more information about Xiaflex treatment or call (973) 942-1315 to schedule a consultation with one of our orthopedic specialists.