Treatment helps hand condition without surgery

October 25, 2010 12:00:00 AM PDT
A newly approved treatment is helping patients with a debilitating condition avoid surgery. The alternative is a simple injection.

Ed Locke and his brother Richard share a family trait which causes their fingers to bend in toward the palm.

"I try to wash my face, I stick my finger in my eye. Little things like that," says Edward.

The condition is the result of a disease called Dupuytren's Contracture. It affects about 3 percent of Americans, mostly as they age. It is caused by a hardening of the fibrous tissue in the hand.

"As time goes on, the hand will pull down to where it can even lock into your palm and you can't straighten your finger," says reconstructive Surgeon Keith Denkler, M.D.

"Little things like trying to clean the counter in the kitchen with a tablecloth, I can't get my hand flat," says Richard.

The treatment typically involves surgery, but Richard is opting for an alternative, newly approved by the FDA. At his clinic in Larkspur, Denkler begins mixing an enzyme solution called Xiaflex. The liquid is then injected into Richard's palm.

Over the next 24 hours, the bacteria-based enzyme will begin dissolving collagen, progressively weakening the hardened fibers.

"Instead of cutting out the tissue, we can actually dissolve it in the office, under local anesthesia," says Denkler.

The next day, Richard returns for step two, in which Denkler will straighten the hand, by breaking the weakened tissue fibers. First there is a slight cracking sound. Then after several minutes, Richard's hand is straightened and the pressure on the tissues in his palm, loosened.

Still, Denkler says Xiaflex produces results similar to surgery. Though he cautions there are limitations.

"Much like the disease can reoccur after surgery, it can reoccur after the enzyme. However, the treatment with the enzyme is just repeat the office treatment," says Denkler.

As for Richard, he's already planning to take advantage of the new flexibility and wants to go golfing.

Xiaflex treatments typically cost about $3,000-$5,000, though that's still more affordable than surgery.


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