Photo: Gravelle

Dupuytren’s disease is a fairly common disorder that I see in my practice. This disease, due to excess collagen production, can cause stiffness in the hand and the inability to straighten the fingers.  Patients with this condition first notice a nodule or bump that may gradually form a rope like cord under the skin. Dupuytren’s disease typically affects the ring and pinky finger and occasionally the area between the thumb and index finger. It is usually not painful, but if it progresses, can affect everyday life. Opening jars, shaking hands, or putting on gloves becomes difficult due to restricted motion of the hand and fingers. If the condition is mild, observation is the treatment of choice. However, if the inability to straighten one or more fingers occurs, treatment is indicated to restore function. Until recently, the only treatment option was to surgically remove the diseased tissue. In 2010, Xiaflex® was approved as a nonsurgical alternative for Dupuytren’s disease. Xiaflex® is a collagenase, an enzyme that breaks down collagen. It is a minimally invasive, nonsurgical treatment that can be dramatically effective with just one injection for appropriate candidates. The procedure involves an injection of Xiaflex® into the thickened tissue of the hand. The patient goes home and the medication begins to dissolve the excess collagen overnight. The patient returns to the office the next day. A local anesthetic is then injected into the area and the affected finger is manipulated into a straight position. The patient then meets with our Certified Hand Therapist to have a splint made, which is worn at night for 4 weeks. This alternative treatment gives patients a more conservative, nonsurgical choice. It can be extremely effective and avoids the risks commonly associated with surgery. If you have any questions about Dupuytren’s disease or this treatment, please call our office to schedule an appointment.