Regain Hand Function Without Surgery
Dupuytren’s contracture is a condition that causes the fingers to bend toward the palm, making it difficult to perform daily activities. This progressive tightening occurs when the connective tissue under the skin of the palm forms thick cords that pull the fingers into a bent position.
For many patients, Xiaflex hand treatment offers a safe, nonsurgical way to straighten the fingers and restore hand function. At Specialty Orthopaedics, Dr. Thomas Neustein, a board-certified orthopedic hand and upper extremity surgeon, provides advanced nonsurgical treatment options for Dupuytren’s contracture in Duluth, Dawsonville, and Braselton, Georgia.
Understanding Dupuytren’s Disease
Dupuytren’s disease is a disorder of the connective tissue in the palm and fingers. It causes collagen buildup that leads to contractures, where cords tighten and draw the fingers inward. This condition can progress slowly over years and may affect one or both hands.
Common symptoms include lumps or nodules in the palm, thick cords running along the fingers, stiffness, and difficulty laying the hand flat. As the condition worsens, patients may find it hard to grip objects, shake hands, or perform tasks requiring finger extension.
Risk Factors and Causes
While the exact cause of Dupuytren’s contracture is unknown, several risk factors make patients more likely to develop it. Genetics play a major role, as the condition often runs in families. Other risk factors include diabetes, alcohol use, smoking, and repeated hand injuries.
Men over the age of 40 are more commonly affected. People with other medical conditions such as arthritis or carpal tunnel syndrome may also be at slightly higher risk of developing connective tissue disorders of the hand.
When to Seek Treatment
Patients should seek treatment when they notice tightening cords, nodules, or a bent finger that does not straighten fully. If you are unable to place your hand flat on a table, that is a sign of functional contracture requiring evaluation.
Early treatment helps prevent severe contractures that may require surgery. Many patients can benefit from Xiaflex hand treatment before the condition becomes too advanced.
Nonsurgical Treatment Options
In the past, treating Dupuytren’s contracture almost always required surgery. Today, advances in hand surgery allow for effective nonsurgical treatment options like Xiaflex injections.
Xiaflex is an enzyme-based medication that targets and weakens the collagen cords responsible for the contracture. By softening the cord, it allows the physician to gently straighten the finger without an incision or stitches.
This approach avoids general anesthesia, large surgical wounds, and lengthy recovery times. Most patients return to normal activities quickly, often resuming daily use of the hand within days.
How Xiaflex Hand Treatment Works
The Xiaflex hand injection is performed in the office under local anesthetic. Dr. Neustein identifies the target cord in the palm and injects the medication, which contains collagenase clostridium histolyticum. This enzyme dissolves the collagen fibers that make up the tight cord.
After the injection, patients rest the hand for 24 to 48 hours while the medication works. At a follow-up visit, the physician gently extends the affected finger to help release the contracture. This simple procedure can dramatically improve range of motion.
What to Expect After the Procedure
It is common to experience mild swelling, bruising, or tenderness in the palm or fingers after Xiaflex treatment. These symptoms usually improve within a few days. Some patients may need to wear a light splint at night to maintain extension.
Dr. Neustein often recommends gentle finger exercises and stretching after the follow-up visit to promote healing and maintain flexibility. Avoid lifting heavy objects for a few days until normal strength returns. Most patients can resume normal activities within a week.
Follow-Up Care and Recovery
A follow-up visit is scheduled one to two days after the injection for finger extension and assessment of results. In some cases, additional injections may be needed if multiple cords are present.
Physical therapy or home exercises may be prescribed to help patients regain motion, reduce stiffness, and strengthen the fingers. Patients should report any signs of increased pain, bleeding, or skin tear at the injection site.
Effectiveness of Xiaflex Treatment
Xiaflex has become the gold standard nonsurgical treatment for Dupuytren’s contracture. Clinical studies show significant improvement in hand function and straightening of affected fingers in most patients.
Compared with traditional surgery, Xiaflex hand treatment offers shorter recovery, less discomfort, and minimal scarring. It allows patients to return to work and hobbies faster and often avoids the risks of surgical complications such as nerve injury or tendon rupture.
Who Is a Candidate for Xiaflex
Xiaflex is appropriate for adults with a palpable cord in the palm causing a noticeable finger contracture. It is not intended for patients with only nodules or early-stage disease without tight cords.
During evaluation, the physician will review your medical conditions, medications such as blood thinners, and any history of allergic reaction to prior injections. Patients with certain skin or soft tissue infections may need to delay treatment until cleared.
When Surgery May Still Be Needed
While many patients respond well to Xiaflex injections, severe or complex contractures may still require surgery. Some cases involve multiple cords, significant joint stiffness, or recurrent contractures that do not fully release.
When surgery is indicated, procedures such as limited fasciectomy, joint fusion, or joint replacement may be discussed. Dr. Neustein provides comprehensive upper extremity surgery for advanced cases that need operative correction.
Other Hand Conditions Treated
In addition to treating Dupuytren’s contracture, Dr. Neustein provides care for many other hand and wrist problems. His practice manages conditions such as trigger finger, carpal tunnel syndrome, tendon injuries, arthritis, and wrist fractures.
Each treatment plan is customized based on the patient’s goals, medical conditions, and level of function. Many of these conditions can also be managed with nonsurgical treatment before surgery becomes necessary.
Safety and Potential Risks
Xiaflex injections are generally safe when performed by a hand specialist. However, as with any procedure, there are risks. Possible complications include swelling, skin tears, bleeding, or temporary numbness.
Rarely, tendon rupture or nerve irritation may occur if the enzyme spreads outside the targeted cord. Patients should contact the physician immediately if they experience severe pain, numbness, or loss of motion after the procedure.
Benefits of Choosing a Specialist-Trained Surgeon
Because Xiaflex injections require precise technique, it is important to choose a specialist trained in hand surgery and experienced in treating Dupuytren’s contracture. Dr. Neustein’s fellowship training in hand and upper extremity surgery ensures the procedure is performed safely and effectively.
With expertise in both surgical and nonsurgical treatment options, he helps patients achieve the best possible outcomes and avoid unnecessary procedures.
Results and Long-Term Outlook
Most patients experience significant improvement after Xiaflex treatment, with straighter fingers and improved ability to perform daily activities. The results are often long-lasting, though some patients may develop new cords over time.
Maintaining regular follow-up visits allows early detection and retreatment if the condition progresses. Gentle stretching and finger exercises can help preserve results and hand flexibility.
Schedule an Appointment
If you are experiencing tight cords, stiffness, or fingers stuck in a bent position, it may be time to treat Dupuytren’s contracture before it worsens. Early diagnosis and nonsurgical treatment can prevent severe deformity and help you regain hand function.
To learn more about Xiaflex hand treatment or other nonsurgical treatment options for Dupuytren’s disease, schedule an appointment with Dr. Thomas Neustein today.
