XIAFLEX® Injection Therapy for Dupuytren’s Contracture

Dupuytren’s Contracture is a condition that affects the hands – and while the exact cause is unclear, there are a number of factors that can increase an individual’s risk.

The condition causes the tightening of fibrous tissue in the palm of the hand – between the skin of the palm and underlying flexor tendons of the fingers.  As the condition progresses, these rope like cords contract and begin to pull one or more fingers inward towards the palm making everyday activities more challenging.

While the exact cause of Dupuytren’s is unclear, risk factors include a genetic predisposition and those suffering from other diseases such as diabetes, cirrhosis and epilepsy.  Though, many sufferers are affected by none of the above.

Symptoms of this condition develop gradually and may go unnoticed.  Patients may first develop a tender lump in the palm of the hand, though associated pain may eventually subside. The condition is generally diagnosed upon physical examination.  Signs of Dupuytren’s include the inability to completely flatten the hand (palm down) on a flat surface, dimples in the palm and puckering over lumps in the palm may be evident.  In more advanced cases, fingers may be curled inward and difficult to straighten.

When Dupuytren’s Contracture is mild to moderate no surgical intervention is required.  Though in advanced cases, it may be necessary to surgically remove the fibrous cords which are pulling the fingers inward.

Until recently, traditional open surgery was the only option available to address the tightening, movement restricting cords to restore normal hand function.

While the innovative and less invasive needle aponeurotomy reduced for many over the past few years the need for more invasive traditional surgical intervention, another even less invasive procedure is gaining attention and showing much promise.

XIAFLEX® injection therapy is a new treatment for Dupuytren’s Contracture, which is an FDA-approved injectable collagenase (extracted from clostridium histolyticum).  Injected directly into the cords, XIAFLEX works to dissolve them – breaking down the fibrous tissue.  The injection takes just five minutes in the office.  Over the next 24 hours, the treatment works to dissolve the contracted cord.  Patients then return to the office the following day and the cord is “released” in a simple procedure.  A “popping” sound is often heard as the finger is pushed open and the cord is released.

Rehabilitation and specialized hand therapy, also known as occupational therapy, can help patients restore hand function following a Dupuytren’s Contracture procedure.

Learn more about Dupuytren’s Contracture, Injection Therapy and other common hand injuries and conditions.


The Different Types of Fractures

A fracture is a break in the bone. Within the hand and upper extremity it can occur anywhere from the fingertip to the shoulder.

Among the most common fractures and dislocations of the hand and upper extremity include:

  • Finger Fractures
  • Distal Radius Fractures (also called Colles Fracture)
  • Scaphoid Fractures
  • Forearm Fractures
  • Clavicle Fractures (collar bone)

There are a number of different types of fractures – partial or complete, simple or compound, clean or shattered …each with their own classifications.  It is important to first define the type of fracture and its severity before determining the most effective treatment plan.

Fractures are defined by the severity of the break and the impact it imposes to surrounding tissue. Some fractures known as partial fractures may only cause a slight crack in the bone, while others may result in a complete break or shattered bone.

A fracture may also be either open or compound, which is a fracture that pierces through the skin creating an open wound.  A closed or “simple” fracture is a fracture that does not break through the skin.

Other classifications that help determine the best treatment plan for your type of fracture include:

  • Transverse Fracture – A fracture that goes across the bone and is situated at a right angle to the long axis of the bone.
  • Greenstick Fracture – A fracture situated on only one side of the bone, causing a bend but not a complete break. These are most commonly seen in children with more “pliable” bones.
  • Comminuted Fracture – A fracture that results in three or more bone fragments.
  • Intra-articular Fracture – A fracture with joint involvement.

Depending on the severity of the fracture, treatment may entail the non surgical realignment of the bone and casting, also referred to as closed reduction. Or surgical repair utilizing fixation support may be indicated.