Xiaflex for Dupuytren’s Contracture

Xiaflex for Dupuytren's Contracture
Xiaflex for Dupuytren's Contracture

In today's post, we discuss Xiafelx for Dupuytren's Contracture - the only FDA-approved nonsurgical treatment when a “cord” can be felt.

First, let's take a step back. Dupuytren's Disease is a hand condition that gradually causes connective tissue under the skin of the palm to thicken and tighten. As this disease progresses, dense cords of tissue form, pulling one or more fingers into a bent position. This condition can interfere significantly with hand function, impacting a person's ability to perform everyday tasks. Although the exact cause is not well understood, genetics appears to play a strong role, and the condition typically affects older adults, especially men of Northern European descent.

Symptoms and Diagnosis of Dupuytren's Contracture

Dupuytren's Contracture often begins with a thickening of the skin on the palm. As the condition progresses, lumps of tissue can develop, which may or may not be painful. These lumps, or nodules, eventually form tight cords that pull one or more fingers toward the palm. The condition typically affects both hands, but usually, one hand is more severely impacted. The ring and pinky fingers are most often involved.

Diagnosis is primarily clinical, based on physical examination and patient history. A manual examination where the doctor presses on parts of the hand and tests for tension in the cords can be enough to confirm the diagnosis. In some instances, imaging studies like ultrasound might be used.

Treatment Options for Dupuytren's Contracture

Treatment for Dupuytren's Contracture aims to restore hand function and alleviate discomfort. Traditionally, surgical intervention was the primary method of treatment, particularly for severe cases. Surgery, often referred to as fasciotomy or subtotal palmar fasciectomy, involves cutting or removing the thickened tissue, thereby releasing the tension in the fingers.

However, surgery comes with risks and a lengthy recovery period, leading to the development of less invasive options. One such treatment is the use of collagenase clostridium histolyticum, commercially known as Xiaflex.

Xiaflex for Dupuytren's Contracture

How Xiaflex Works

Xiaflex is an injectable medication that contains enzymes designed to break down the collagen in the cords formed by Dupuytren's Contracture. This treatment involves a series of injections directly into the cord of the affected finger. After the injection, doctors manipulate the finger to help break the cord, which can relieve the tension and restore finger movement.

The primary advantage of Xiaflex over surgery is that it’s a minimally invasive procedure. It can be done in an outpatient setting, does not require anesthesia or an operating room, and involves a significantly shorter recovery time. Many patients are able to resume regular activities within a few days of the treatment, as opposed to weeks or months required for postoperative recovery from surgical intervention.

Effectiveness of Xiaflex for Dupuytren's Contracture

Xiaflex has been shown to be effective for many patients, with clinical trials indicating significant improvements in finger straightness and hand function. Nevertheless, it’s not without its downsides. Potential side effects can include swelling, pain at the injection site, and in rare cases, tendon rupture or other complications. It’s important for patients to discuss these risks with their healthcare provider to ensure that Xiaflex is the right choice for their specific situation.

For individuals considering this treatment, consulting with a hand specialist like Dr. Brandon Donnelly can provide valuable insight. Dr. Donnelly specializes in the management of Dupuytren's Contracture and offers comprehensive information on both traditional and novel treatment options. 

Have Questions About Treating Dupuytren's Contracture?

Managing Dupuytren's Contracture effectively requires a tailored approach to each patient’s needs. While Xiaflex offers a promising alternative to surgery, Dr Donnelly will help you weigh the benefits and risks of all treatment options so you can make an informed choice toward restored hand function and improved quality of life. If your finger is starting to curl or you found a lump on your hand, contact Dr. Donnelly’s office to schedule an appointment today. Early intervention is the key to maintaining your quality of life.

About Dr. Brandon P. Donnelly, MD

Dr. Brandon P. Donnelly is a board certified hand surgeon with Pontchartrain Orthopedics & Sports Medicine.  Dr. Donnelly completed his hand and microsurgery fellowship at the prestigious Philadelphia Hand to Shoulder Center. Dr. Donnelly treats all ages of patients in the greater New Orleans area for hand, wrist, and elbow conditions. 

This site is not intended to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. Through this website and links to other websites, Brandon P. Donnelly, MD provides general information for educational purposes only. The content provided in this website and links, is not a substitute for medical care or treatment. You should not use this information in place of a consultation or the advice of your healthcare provider. Brandon P. Donnelly, MD is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this site.