A WellMoment by Dr. Robert Coats< Back to WellMoments

  • Dr. Coats  

    Dramatic, Simple Relief from Dupuytren's Contracture. Another WellMoment brought to you by WellGroup Health Partners Sometimes confused with Trigger Finger, Dupuytren's Contracture is a systemic disease that causes a progressive, abnormal thickening of the tissue in the palm of the hand. Over time, a rope-like cord may develop that pulls the finger permanently towards the palm. The cords are not only visible, but palpable, meaning they can be felt – it's like there's a small twig or branch underneath the skin.

The ring and little fingers are the most commonly affected by Dupuytren's Contracture. Though not painful, the condition can make it difficult or even impossible to perform everyday tasks such as shaking hands or putting on gloves.

In the past, a delicate, complex surgery was the only recourse for Dupuytren's suffers. But in February 2010, a highly effective, non-surgical treatment called XIAFLEX® was approved for use by the FDA. This breakthrough therapy involves a simple injection with a very small gauge needle and small volume of medication. 24 hours later, the patient returns and the fingers are numbed with a local anesthetic which enables manipulation of the fingers to straighten them.

The manipulation usually takes less than a minute and a loud pop is heard when the cord breaks. Patients are able to begin moving their hands immediately, first registering disbelief which is quickly replaced by joy.

Before XIAFLEX®, the only alternative to straighten a Dupuytren's Contracture was surgery. Even the most successful surgeries leave a scar and require post-operative therapy and splinting. It is usually months before patients can effectively use their hands because of the trauma involved. What's more, there is a level of reoccurrence with Dupuytren's Contracture because it is a disease process. While neither surgery nor medication can alter the disease, the injections are far less traumatic and may be repeated.

Fortunately most patients are able to benefit from XIAFLEX® injections and manipulation. Only patients who have significant scar tissue from previous hand surgeries or non-palpable/inaccessible cords are not candidates for the procedure.

There are few things I've done that make me as happy as seeing how happy this makes patients. It's nice to be able to do something and 24 hours later have a tangible result.

Robert W. Coats II, M.D., is a Board Certified Orthopedic Surgeon who specializes in hand and upper extremity surgery. He has completed a hand fellowship and earned a Certificate of Additional Qualification (CAQ) for hand surgery. He practices at WellGroup Health Partners and sees patients in Chicago Heights, Olympia Fields and Frankfort.