6 February 2013

Lets talk about Dupuytren's Disease

Want to know more about Dupuytren’s disease? Are you or is someone you know suffering from this hand condition? Check out our latest blog on this painful but common problem.

Dupuytren’s disease is a common but very painful condition. Mr Brian Cohen, Consultant Orthopaedic Surgeon and specialist in upper limb conditions discusses the disease and the different treatment options available.  

What is Dupuytren’s disease?

Dupuytren’s disease is a common, benign painless condition it affects the tissue in the palm of the hand which thickens and can result in contracture of the fingers most commonly the little and ring fingers.

Dupuytren’s disease is common in Northern Europe, particularly Scandinavia. It occurs more commonly in men than women and usually in later life, over the age of 40. The condition is thought to run in families however trauma, alcohol, diabetes and liver disease have all been identified as possible associations.

There are three treatment options, radiotherapy, surgery and Xiapex injection therapy.

Radiotherapy was approved in 2010 by the National Institute of Clinical Excellence for treatment of early stages of diagnosis .

Surgery has in the past been the mainstay of treatment however this relies on a good deal of skill, anaesthetic and has a number of potential significant complications

 The third option is Xiapex injection treatment, marketed my Pfrizer. Xiapex was launched in 2011 and is a collagenase, an enzyme that breaks down the Dupuytren’s tissues and is the first medicine licensed for adults with Dupuytren’s contracture who have a palpable cord.

 If you have Dupuytren’s in multiple fingers your consultant will advise you on which finger should be treated first as only one cord at a time can be treated. 

What is involved in the treatment?

Xiapex Treatment consists of two visits 24 hours apart. The first visit involves the injection of Xiapex the second a manipulation of the finger to correct the contracture. 

On your first visit you will come here to the clinic. As it is not a surgical procedure you will not need to go to hospital and no incision will be required. A fine needle is used to inject directly into the cord. After your injection the hand will be wrapped in a gauze dressing, you will then need to wait here at the clinic for 30 minutes to make sure you have no allergic reactions to the medicine.

The next day the hand is manipulated under local anaesthetic back in the clinic. 

Correction of the finger is immediate however you will need to wear a splint for several months after the procedure to maintain the correction.

See more information on our YouTube video