Dupuytren's contractures (also known as Viking's Disease) is a condition that is caused by thickening of the tissue that is under the skin in the hands. Nodules, pits, and cords can occur in the hands, which may cause the fingers to flex abnormally into the palm. Mild cases are usually asymptomatic, but severe cases can cause significant distress to one's life and leave the hand in a nonfunctional position. Traditionally, the treatment was surgical only, and involved in taking out the cords. Although effective, there are certain downside to surgery. There is the potential of hurting nerve or vessels in the area, the risk of infection, and the obvious cosmetic deformities associated with a scar. There are situations in which surgery is the more desirable option, such as when there is severe contracture of the fingers. However, over the past decade, a product which can dissolve the cords has been introduced to the market. Collagenase (Xiaflex is the trade name) is an enzyme that can dissolve the cords, and allows the surgeon to non-surgically straigthen the fingers. Collagenase is injected into the cords on day 1, and 28-72 hours later, the fingers are manipulated in the clinic under local anesthesia. This is a much less invasive and time efficient way to treat most mild to moderate forms of Dupuytren's contractures.
I am comfortable with both treatments and can offer the patient either option, depending on the severity of his/her symptoms. Please come by for an evaluation if you had that your hand is in a flexed position and cannot be straightened.
