Nonsurgical Treatment for Dupuytren’s Contracture
Dupuytren’s contracture is a medical condition that limits mobility in the fingers through rough cords that develop from tightened tissue. As an alternative to surgical treatment, the Hand Center of Louisiana offers XIAFLEX®, an enzyme injection that restores finger motion by treating the cord in the patient’s hand. If you have received a diagnosis of Dupuytren’s contracture or experience any symptoms of this condition, explore some nonsurgical treatment options.
What Is XIAFLEX®?
XIAFLEX® is the only FDA-approved treatment for Dupuytren’s contracture that does not require surgery. A hand specialist will inject this enzyme treatment directly into the cord that’s causing limited mobility in the finger. The enzyme releases the cord. Within 24-hours post injection, a release of the cord is performed with local anesthetic. You can conveniently have this procedure done at the Hand Center of Louisiana office.
You may want to get XIAFLEX® injections for Dupuytren’s contracture if you feel a cord in your hand. The hand specialist follows this procedure.
- Injection: During your treatment, the physician will inject XIAFLEX® directly into the cord. You may receive more than one injection if you have several contractures. After the injection, your doctor wraps your hand with bandages and gives you specific instructions for at-home care. These instructions often include keeping your hand lifted until bedtime and limiting movement in your fingers. You should also avoid straightening your finger yourself.
- Follow-up visit: You may have another appointment with the doctor as soon as 24 hours after treatment.
- In-home treatments: After the doctor extends your hand, they will probably recommend some exercises for Dupuytren’s contracture. You might have to wear a splint at bedtime and allow yourself a rest period before resuming normal activities.
What Is Dupuytren’s Contracture?
Dupuytren’s contracture disease is a medical condition affecting the layer of tissue underneath the skin in the palm and fingers. This layer thickens and tightens over time, resulting in the fingers pulling inward. As symptoms worsen, it can be challenging to use your hands for daily activities. Instead of going through surgery, you can get nonsurgical treatment to help slow its progression and improve motion in your fingers.
At first, you may notice lumps in the palm of your hand. These lumps could cause pitting on your palm’s surface as the tissue tugs at the overlying skin. The diseased tissues often develop into thick cords that could pull your fingers into a bent position.
Since most cases of Dupuytren’s contracture are mild, you will not always need treatment. Over time, it could get worse, making it challenging for you to keep your fingers straight. In that case, you’ll need to get treatment to fix the contracture and have full mobility in your fingers. It’s critical to treat this disease as soon as possible to prevent permanent damage.
What Causes Dupuytren’s Contracture?
There is no known cause of Dupuytren’s contracture, but there are several risk factors.
- Gender: Men are three times more likely to have Dupuytren’s contracture than women. Men also tend to experience more severe symptoms.
- Ancestry: People of northern European and Scandinavian descent are more prone to Dupuytren’s contracture.
- Heredity: This medical condition usually runs in the family.
- Alcohol use: Drinking alcohol could worsen symptoms of Dupuytren’s disease.
- Existing medical conditions: Those with seizure disorders and diabetes are more likely to develop Dupuytren’s contracture.
- Age: This condition’s severity increases with age. It’s most prevalent in people over age 50.
How to Know If You Have Dupuytren’s Contracture
Dupuytren’s disease usually takes a long time to develop. You may notice the following symptoms if you have this medical condition.
- Nodules: You might see one or more lumps in the palm of your hand. At first, the nodules may be tender, but they get thicker and more rigid over time. You may also have a deep indentation in the skin by the nodules.
- Cords: As the nodules contract and thicken, the tissue under your skin develops into dense, tough cords. They can prevent your fingers or thumb from spreading apart or straightening.
- Contractures: The tight cords pull one or more of your fingers toward the palm, reducing their mobility. Your ring and little fingers are most prone to contractures, but any of your fingers, even the thumb, could develop them. You will most commonly see a contracture near the knuckle.
- Limited use of your hand: As Dupuytren’s contracture develops, you might have difficulty keeping your finger straight. Pay attention to what happens during simple activities, such as holding large objects or putting your hand in your pocket. Your doctor may ask you to place your hand flat on the table. If you cannot do so, you may have Dupuytren’s contracture.
How to Treat Dupuytren’s Contracture
A Dupuytren’s contracture surgeon will create a plan based on your age, overall health and existing medical conditions. After conducting some tests, they can figure out how severe your case is and whether they expect it to get worse. If the disease progresses slowly and you can still use your hands, you probably do not need Dupuytren’s contracture treatment. The doctor will most likely monitor your symptoms over time.
Most treatment techniques target the cords that pull your fingers toward the palm. Explore these nonsurgical treatment options for Dupuytren’s contracture.
- Steroid injection: A steroid shot may help relieve pain from the lumps in your hand. It can also prevent your symptoms from getting worse. In some cases, you may need to get more than one injection to treat the disease effectively.
- Needle treatment: Besides a steroid injection, your doctor could also insert a needle through your skin to break the cord pulling your finger toward the palm. You can get this procedure done more than once if the contractures come back. The needling technique does not involve an incision, and you can have it done on several fingers at once. After the procedure, you should not need much physical therapy to increase mobility in your hand.
- Changes to your lifestyle: You can treat mild Dupuytren’s contracture by adjusting your daily habits. Protect your hands by using insulation when gripping tools and using gloves while grasping heavy objects. It is also helpful to monitor your symptoms to see if they worsen over time.
Schedule an Appointment With the Hand Center of Louisiana
If you have any of the symptoms of Dupuytren’s contracture, you may want to get your hands checked out to discover if you need treatment. Join the thousands who have benefited from full-finger extension following the nonsurgical release. Contact the Hand Center of Louisiana online or call 504-454-2191 to help you determine if XIAFLEX® is the best treatment option for you.