dupuytrens

PAUL, PUMPKINS, and THE POPE

PAUL, PUMPKINS, and THE POPE
October 7, 2015

Hands and injuries have been much in the news of late, from hand transplants to robotic hands to injuries.

Football fans, for example, know about Jason Pierre Paul (JPP), the defensive end for the NY Giants who blew off parts of his hand with fireworks. Well, we’re way past July 4, but every season brings its hazards.
Coming up soon:
Halloween
The Goal: carve the pumpkin, not your hand!

Some tips, especially for those of you with kids/grandkids:



    And the Pope?

    Well, I didn’t notice Pope Francis doing this on his recent visit, but maybe I missed it. Often when a Popes blesses the flock, he has his last two fingers bent.



    This is known as Benediction Hand and may have its origin back in the Middle Ages or earlier. One of the early Popes may have had an injury to the Median or Ulnar nerve or possibly an untreated case of Dupuytren’s contracture.

    The good news: these conditions are all treatable in the 21st century if you catch them early enough.



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    THE BEST TIME TO TREAT DUPUYTRENS

    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.

    For more information see:
    www.dupuytrenscure.com

    DUPUYTRENS CONTRACTURE

    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:
    www.dupuytrenscure.com