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Suggest treatment dupuytrenes contracture in hands

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Posted on Wed, 9 Jul 2014
Question: I have dupuytrenes contracture in both hands. I was told not to ever do anything as long as I could lay my hands flat on a table. The condition has worsened over time however, my fingers have not drawn up in a frozen position like my Mother. My daughter has inherited dupuytrenes and told me today about an injection that she will have to hopefully cure her rigid (frozen) finger. The name of the medicine that will be injected is Xiaflex or Ziaflex? I am not sure of the spelling. I would be most interested in this treatment and would appreciate information.I question if a hand surgeon would be the specialist to answer this? Thank you.XXXX
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Answered by Dr. Rovena Murati (1 hour later)
Brief Answer:
Xiaflex is a new medicine for Dupuytren's contrac.

Detailed Answer:
Dear XXXX
I read carefully your query and understand your concern.

A Dupuytren's contracture is a localized formation of scar tissue around the tendons that flex the fingers beneath the skin of the palm of the hand.

A number of treatments are available to slow the progression of Dupuytren's contracture and relieve symptoms.
The treatment depends on the severity and the underlying condition of the affected individual.

There are 2 major treatment options :
1)Non-surgical treatments (for milder cases) that include -Radiation therapy -A new medicine called collagenase clostridium histolyticum (Xiaflex).
2)Surgical treatments (for more severe cases) including -Needle fasciotomy -Open fasciotomy -Fasciectomy

A newer treatment for a Dupuytren's contracture is collagenase injection (Xiaflex).
Collagenase clostridium histolyticum (Xiaflex) is a new medicine for Dupuytren's contracture .
It is directly injected into the contracted "cord" of scar tissue that causes the Dupuytren's contracture.
The medicine contains special proteins that can weaken the cords.
After having the injection, you return to your doctor 24 hours later, and they will straighten your bent finger and stretch it out for 10 to 20 seconds. This breaks the cord and should help increase the range of movement in your bent finger .

Collagenase clostridium histolyticum is usually given once every 4 weeks.

You may need to wear a splint on your hand for a short time to keep your fingers straight, especially at night. You may also need to perform daily finger exercises.

I suggest to consult an Orthopedic Surgeon and I am sure he will try to chose the best option of treatment for your case.

Hope my answer has helped.
If you have additional questions,please feel free to write me,I will be happy to help.

Wish you good health.

Dr.Rovena Murati
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rovena Murati (4 hours later)
Thank you for responding. I did request a hand surgeon to answer my question.
Can you forward my question to a hand surgeon (Orthopaedic Surgeon)? I am scheduled later in the year at Mayo Clinic but trying to get the most up to date information on treatment for dupuytren's contracture.
doctor
Answered by Dr. Rovena Murati (10 hours later)
Brief Answer:
Post again your query as a specialist query.

Detailed Answer:
Hello again!
I am sorry for the confusion.

In order to get an answer from an Orthopedic Surgeon you should post again your question,specifying in the selected field that it is a query for an orthopedic surgeon and in this way it will appear as a specialist query.

I wish you all the best.
Take care

Dr.Rovena Murati
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Rovena Murati

General & Family Physician

Practicing since :2013

Answered : 1243 Questions

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Suggest treatment dupuytrenes contracture in hands

Brief Answer: Xiaflex is a new medicine for Dupuytren's contrac. Detailed Answer: Dear XXXX I read carefully your query and understand your concern. A Dupuytren's contracture is a localized formation of scar tissue around the tendons that flex the fingers beneath the skin of the palm of the hand. A number of treatments are available to slow the progression of Dupuytren's contracture and relieve symptoms. The treatment depends on the severity and the underlying condition of the affected individual. There are 2 major treatment options : 1)Non-surgical treatments (for milder cases) that include -Radiation therapy -A new medicine called collagenase clostridium histolyticum (Xiaflex). 2)Surgical treatments (for more severe cases) including -Needle fasciotomy -Open fasciotomy -Fasciectomy A newer treatment for a Dupuytren's contracture is collagenase injection (Xiaflex). Collagenase clostridium histolyticum (Xiaflex) is a new medicine for Dupuytren's contracture . It is directly injected into the contracted "cord" of scar tissue that causes the Dupuytren's contracture. The medicine contains special proteins that can weaken the cords. After having the injection, you return to your doctor 24 hours later, and they will straighten your bent finger and stretch it out for 10 to 20 seconds. This breaks the cord and should help increase the range of movement in your bent finger . Collagenase clostridium histolyticum is usually given once every 4 weeks. You may need to wear a splint on your hand for a short time to keep your fingers straight, especially at night. You may also need to perform daily finger exercises. I suggest to consult an Orthopedic Surgeon and I am sure he will try to chose the best option of treatment for your case. Hope my answer has helped. If you have additional questions,please feel free to write me,I will be happy to help. Wish you good health. Dr.Rovena Murati