Posted by Brigham and Women's Hospital August 22, 2013
Dupuytren’s contracture, a benign thickening of the connective tissue in the palm that can extend into the fingers, has often been referred to as Viking’s Disease because of its prevalence among people of Northern European descent. The exact origins of Dupuytren’s are not entirely clear, as the condition also can be found among populations in Spain, Japan, and other regions. Nevertheless, Dupuytren’s impacts millions of Americans and can be very disabling, resulting in permanently bent fingers.
“Until recently, the most effective treatment for Dupuytren’s involved invasive hand surgery with a long recovery period and extensive rehabilitation,” says Dr. Philip Blazar, an orthopedic surgeon at Brigham and Women’s Hospital (BWH) who specializes in Dupuytren’s contracture.
Five years ago, Dr. Blazar participated in a national trial investigating an enzyme therapy for patients with Dupuytren’s. The study found that, on average, patients who received the enzyme therapy improved their motion from 40 to 80 degrees of motion. The treatment has since been approved by the FDA.
Using this approach, the enzyme is injected into the affected area/finger. The next day, Novacaine is given to numb the hand before an orthopedic specialist extends the finger to break down the collagen in the Dupuytren’s cord. The therapy frequently causes some bruising and swelling in the hand, which subsides within two weeks. Excess collagen from the Dupuytren’s cord broken down by the enzymes is reabsorbed by the body. If needed, additional injections can be given at four-week intervals. Surgery, by comparison, involves anesthesia, splinting for six weeks after surgery, and lengthy hand therapy.
“Many patients with Dupuytren’s have finally received some relief without surgery with this promising treatment,” says Dr. Blazar.
Want to learn more about hand conditions treated at BWH? Check out our hand and upper extremity services page.– Jessica F.