Apr 2014


Since DUPUYTRENS is a non-life threatening condition and one that usually progresses slowly this is one of those conditions where the patient has a large role to play in decision making i.e a lot will depend on the patient's lifestyle, type of work, hobbies, sports etc...How much does the contracture interfere with function for that individual patient? Having said that, there is a simple test called the "table top test" which you fail once you can't put your palm flat on the table. Usually surgeons talk about 30 or 40 degrees of contracture, though there is a trend towards earlier treatment. Luckily, there is now a very viable alternative to surgery called Xiaflex which is a two part collagenase injection and manipulation done usually in the office.

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DUPUYTRENS, in simple terms, is a thickening of the layer of tissue just beneath the palm. It occurs unpredictably, though there is some genetic component and some relationship with trauma. But that doesn’t mean that your dad or mom had it. And it doesn’t mean that if you’re real careful you won’t get it.

If the Dupuytrens gets bad enough, it can start to pull the fingers, and especially the middle, ring, and pinky towards the palm. This can get annoying and if severe enough cause problems with using the hand.

Luckily, there is a well studied and successful alternative to surgery that has been developed over the last 25 years and which got FDA approval in the last few years. It is called Xiaflex, and it is a type of Collagenase. You come to the doctors office on Day#1 and he/she gives you a set of three injections. 24 hours later you come back and the finger gets straightened. The Collagenase works by weakening the thick fibrotic cords that pull the finger in.

While it seems miraculous and is an excellent alternative to surgery, there is no perfect solution. Even with surgery, the Dupuytrens can come back. But with Xiaflex, there is generally a quicker recovery and the results are usually just as good, if not better.

For more info see: