Dupuytren’s contracture: curled fingers

A doctor holding a patient's hand using white gauze

Q. What can be done for my curled fingers?

Without the ability to conduct a personal examination or know your age, I can only theorize that your condition may be Dupuytren’s contracture, which is a thickening of the fibrous tissue layer underneath the skin of the palm and fingers. Although painless, this thickening and tightening (contracture) can cause the fingers to curl.

How do you treat Dupuytren’s contracture?

Recently the FDA approved an injection therapy for Dupetryn’s contracture. The collagenase enzyme has been around for a long time experimentally. The clinical use of this biochemical agent involves an injection performed in the office to digest the cord collagen. Patients who have contracture at the MCP (the knuckle) or at the PIP (the first joint) from Dupetryn’s fibrosis are candidates for the injection therapy. The fibrosis in the palm is not as responsive to injection therapy and may require excisional surgery using tourniquet anesthesia.

Patients who have the finger contracture can be injected monthly up to three times. The patient is seen the next day for a mobilization maneuver to hopefully break the cord. Tendon rupture is a small risk of the injection, because it contains high collagen content and is in close proximity to the fibrotic cord in the finger. I am credentialed in the safe use of Xiaflex™ collagenase injection, which is not a cosmetic procedure.

For elderly patients, this collagenase injection therapy is ideal if you are on anti-platelet or Coumadin agents and you do not want to have surgical intervention. I suggest you make an appointment so I can find the cause of your specific condition.

WARNING: The videos below are very graphic in nature.

Dr. Paul Vanek MD, FACS
Vanek Plastic Surgery
9485 Mentor Ave #100
Mentor, OH 44060

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Dr. Paul Vanek

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