New FDA approved Nonsurgical Treatment available for Dupuytren's contracture

[mtomaino]

After many years of investigation of of feasibility, safety and efficacy---a bacterial enzyme injection which can dissolve the duputren's cord (clostridial collagenase) is now available. For more informtion visit www.xiaflex.com

This new treatment option is available for appropriate candidates at Tomaino Orthopaedic Care. It involves an injection on day 1 followed the next day by a gentle manipulation. Formal therapy is not required, but a splint is recommended at night for several months to keep the fingers in a straightened position.

[my2boys]

That is exciting news for those who have lived with the condition for years. I have a few additional questions: will this treatment allow me to get back to work/normal activity sooner than surgery? does one treatment take care of the contracture, mine is more severe, and I know I have had dififculty in the past getting my insurance to cover new treatments. Will you/your staff be able to help me check this out with my insurance?

Thank you!

[mtomaino]

Thank you for your questions------very good questions!!

Regarding "Return to work" —because this is a nonsurgical treatment--which involves an injection and then a manipulation the next day, and no need for therapy other than a splint--one can resume normal activity after the successful cord release (within a few days).

For a more severe contracture, for example-- contractures from 20-100 degrees , studies have indicated an average of 1.7 injections....so the truth is that 1-2 injections may prove effective.

Regarding concern about insurance coverage for treatment—my office staff will be able to check with insurance to see what coverage will be including what your responsibility is. This will be done before any drug is ordered. In short, I will evaluate a patient with Dupuytrens and based on the assessment check this all out or, alternatively, make the determination that xiaflex is not an option.

Please let me know if you have any additional questions.

[mtomaino]

I have just added a link to a news report of a satisfied patient after this type of treatment.
Visit the Hand page of this website, and under popular topics, click on Dupuytrens disease. At the bottom of the page see the link regarding Xiaflex.

[Joseph Socie]

Dr Tomaino, I had a rotator cuff surgery that went terribly wrong leaving my left arm and hand severely atrophied. Since the surgery performed 3 years ago, my little finger as well as my ring finger has contracted back toward the palm. In your medical opinion, would the use of this procedure into those 2 fingers allow me to straighten them back out and thereby allow me to wear a glove on that hand during the winter months. I know I will never regain the use of this hand since there is no muscle to allow the nerves to reattach to, but I can at least uncurl the hand.

[mtomaino]

Joe

I can't say for certain without evaluating the cause of the "curling up", but this injection (collagenase) is specifically for contracture caused by Dupuytren's tissue----and this is unlikely the cause of your contracture. I am sorry for the delay in answering your question.