Dupuytren’s Contracture

What is Dupuytren’s Contracture?

This is a progressive hand condition that limits the ability to move or straighten the fingers.

It is caused by abnormal buildup of collagen (fibrous tissue) around the tendons that flex the fingers. This accumulation often thickens into rope-like cords on the palm at the base of the joint where the fingers meet the palm. As the disease progresses, it shortens and pulls the fingers into the palm, sometimes making it impossible to lay the hand flat or even wash the hands. It is most common in the ring and little fingers.

What causes Dupuytren’s contracture?

The cause is unknown. It affects both men and women, and about 50% of cases occur under age 65. It is a progressive disorder that develops over years.

Who is at risk?

  • Men over 50, and men and women over the age of 40 who are of northern European descent
  • It affects men six times more than women
  • It often runs in families so it may be hereditary
  • It is associated with certain medical conditions like diabetes, epilepsy and alcoholism
  • The risk increases with age

Signs and symptoms

Initially, lumps form on the palm at the base of the affected finger(s). They may be noticeable, but are typically not painful. No one can predict how the disease will progress. Many cases are mild and require no treatment. Studies show that about 20% of cases are severe.

Some people only have slight disability with these lumps and cords, and others will progress to the complete inability to clasp the hand, losing the grasping function. As the disease progresses, thick cords develop from the palm and spread to the fingers. It may affect only one or both hands.

XIAFLEX

XIAFLEX is the first and only FDA approved nonsurgical treatment option proven in clinical studies to work in adults with Dupuytren’s contracture when a cord or cords can be felt. Studies show that XIAFLEX injections provided a majority of patients with the ability to straighten their fingers and improve their range of motion.

XIAFLEX is made of collagenase clostridium histolyticum (CCH), an enzyme that dissolves collagen. When injected directly into the cord, it breaks down the collagen. Up to 3 injections given 30 days apart coupled with finger extension procedures can help breakup the cords. Most people need 1-2 injections for this to happen.

XIAFLEX injections offer more rapid recovery of hand function than minimally invasive procedures to treat contracted cords in the hand.

When required, XIAFLEX injections will be recommended by the excellent hand surgeons at Orthopaedic Specialists of North County. Treatments are geared to reducing the symptoms and improving function of the hand.

The Procedure

Under local anesthetic, XIAFLEX prescription medication is carefully injected directly into the cord(s) on the affected hand. Your hand will be wrapped in gauze and you will be told how to care for your hand at home.

1-3 days after injection, you will return to the Orthopedic Specialists’ office near you, where your surgeon will attempt to straighten your finger(s), and apply a splint to keep your fingers as straight as possible. Again, you will receive full instructions at the office.

If, after four weeks, you remain unable to extend your finger(s) your hand surgeon may repeat the procedure up to two more times, and each time conduct finger extension exercises.

The most common side effects include:

  • swelling of the injection site or the hand
  • bruising or bleeding at the injection site
  • pain or tenderness of the injection site or the hand
  • swelling of the lymph nodes (glands) in the elbow or armpit
  • itching
  • breaks in the skin
  • redness or warmth of the skin
  • pain in the armpit

Studies show that about 15% of patients may be hypersensitive to the ingredients in XIAFLEX, which can cause itching, after injections.

Your board-certified Hand Surgeon at OSNC have undergone the precise training required to administer this medication and will explain the risks and benefits of XIAFLEX. We are confident that we can successfully provide you with this noninvasive way to live with Dupuytren’s contracture, restore function, and help you live a more independent life.

We treat patients in Greater San Diego County including Oceanside, Vista, San Marcos, Escondido, Carlsbad, Encinitas, and Solana Beach, California. Schedule a consultation today to learn how you can live with this disease.


"The entire team at OSNC is great, very professional and took the time to put me at ease. And I only have praise for the Dr. Erik Stark, a wonderful doctor who never disappoints!" Patient of Dr. Erik Stark
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