Blooming Prairie, Minnesota

Your symptoms match those of Dupuytren’s contracture, a sometimes disabling (but not dangerous) condition that pulls fingers toward the palm and locks them there. It’s unrelated to arthritis. “Dupuytren’s causes painless contraction of fibrous tissue directly under the skin of the palm and fingers, and may be associated with nodules or cords in the palm. Over time, an affected finger may bend into a hook,” notes Dr. Taizoon H. Baxamusa, who is affiliated with the University of Illinois at Chicago and the Illinois Bone & Joint Institute in Morton Grove. “The cause of Dupuytren’s is not known; however, there is a strong hereditary association, especially among people of Northern European or Scandinavian descent. It’s more common in men than women, and risk increases with age.

“Dupuytren’s is sometimes confused with trigger finger, tendonitis, or arthritis. Try this simple test: Place the hand and fingers flat on a tabletop. If you are unable to do so, or the finger curls under, you may wish to seek a formal evaluation by an orthopaedic surgeon.”

New treatments include nonsurgical needling techniques and injections of the biologic drug Xiaflex.

Crooked Finger? The Saturday Evening Post

A first-of-its-kind experimental therapy featured last fall in the Medical Update http://www.saturdayeveningpost.com/2009/09/19/wellness/medical-update/hand-therapy-advancements.html is the first drug FDA-approved for treating Dupuytren’s, a condition that progressively pulls fingers toward the palm and locks them there.

The new biologic drug Xiaflex is injected into the hand  to weaken and “break” abnormal cords of connective tissue that are hallmarks of the disease, restoring full motion and function of affected hands and fingers.

“Xiaflex is an enzyme that comes from the bacterium called Clostridium histolyticum,” study investigator Dr. Thomas Kaplan explained to the Post. “In Dupuytren’s disease, multiple fibers of collagen run along the cord. When the enzyme is injected into the cord, it starts ‘cutting’ the fibers into progressively smaller fragments, weakening the cord in that section.”

Drug manufacturer Auxilium Pharmaceuticals, Inc. expects shipments of Xiaflex to reach physicians in late March 2010. In the past, conventional surgery was the only way to remove Dupuytren’s cords affecting the MP joint (where the finger meets the palm) and the PIP joint (the finger’s middle joint.)

“People with Dupuytren’s contractures that are severe enough to warrant surgical treatment finally have a nonsurgical option to correct their deformities,” reports Dr. Larry Hurst, who led the Xiaflex studies at SUNY Stony Brook where he is a professor and Chair of the Department of Orthopaedics.

Those considering Xiaflex therapy need to consult an expert to discuss the new procedure, its risks, and alternatives, adds Dr. Hurst.

Dupuytren’s contracture is most common among Caucasians (especially those of Northern European descent) over age 50 and tends to run in families.

For more information about Xiaflex and Dupuytren’s disease, click here XIAFLEX (collagenase clostridium histolyticum)| Official Site or call Auxilium at 1-877-942-3539. In the future, the Web site will also feature patient stories and an online tool to locate trained specialists in your area.

New Therapy Straightens Fingers (Dupuytren’s Disease) The Saturday Evening Post