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Enzyme Injections for Treatment of Dupuytren’s Contracture

For those who suffer from Dupuytren’s contracture, there is a non-invasive treatment option that you may not know about - collagenase injections with Xiaflex®. Instead of having surgery, an injection of collagenase – a type of enzyme that breaks down abnormal collagen, the tissue that causes the contracture – can provide long-lasting improvement.  


Dupuytren’s contracture, which causes your fingers to bend in toward the palm, can interfere with daily activities if left untreated.  It becomes impossible to straighten the fingers.  Shaking hands or simply placing the hand in your pocket may become difficult.  The layer of tissue under the skin of your palm becomes thicker and forms cords made of fibrous collagen. Collegenase works by weakening and dissolving these cords, allowing the palmar fascia to be stretched mechanically until the cord is snapped and the finger can be extended.  

Surgery is still the gold standard treatment for Dupuytren’s, but collagenase injections are an effective, FDA-approved, alternative that is suitable for many patients. 

It may be necessary to receive multiple injections to achieve the final outcome; however, a recent study done at the University of Texas Southwestern Medical Center by Malafa et al., reported a 76% success rate with a single injection of collagenase. There was a 6% recurrence rate (2 out of 37 joints) within the first 30 days, and no other recurrences within 6 months.  Skin tears were reported by about 38% of patients in the study, all of which healed completely and were not serious.  They developed a special protocol using hand therapy, and the paper was published in February 2016.

A similar treatment for Dupuytren’s contracture, needle aponeurotomy (NA) works by physically cutting the fibrous cord.  NA requires a thin needle to be scratched across the cord to weaken it mechanically. Studies to determine which treatment has longer lasting effects are currently underway.
 

Reference:

Malafa MM, Lehrman C, Criley JW, Amirlak B. “Collagenase Dupuytren Contracture: Achieving Single Treatment Success with a Hand Therapist-Based Protocol,” Plast Reconstr Surg Glob Open. 2016 Feb 26;4(2): e629. doi: 10.1097/GOX.0000000000000565. eCollection 2016. (Accessed June 2, 2016). 
 

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.