From the Research
Treatment for multiple palmar fibrosis, also known as Dupuytren's contracture, should prioritize collagenase injections (Xiaflex/Collagenase Clostridium histolyticum) for early stages, given its effectiveness in enzymatically dissolving the contracted tissue, as supported by recent literature 1.
Overview of Dupuytren's Contracture
Dupuytren's contracture is a chronic condition characterized by the thickening of the palmar fascia, leading to flexion deformity of the fingers. The condition progresses over time, impairing hand function and quality of life.
Treatment Options
Treatment strategies depend on the severity of the condition:
- For mild cases, observation may be sufficient.
- As the condition progresses, treatment options include:
- Needle aponeurotomy (percutaneous needle fasciotomy), where a needle breaks up the contracted tissue.
- Collagenase injections (Xiaflex/Collagenase Clostridium histolyticum), which enzymatically dissolve the contracted tissue.
- Surgical fasciectomy to remove the affected tissue.
- Physical therapy is often recommended after any intervention to maintain hand function and range of motion.
- Splinting may be used post-procedure to maintain finger extension.
Choice of Treatment
The choice of treatment depends on the stage of disease, degree of contracture, patient's age, and overall health. Early intervention is crucial as the condition tends to progress over time. The disease involves abnormal collagen production and contraction in the palmar fascia, causing fingers to bend toward the palm, most commonly affecting the ring and little fingers. Recurrence is possible with all treatment methods, and patients should be monitored for signs of disease progression, as highlighted in a recent review 1.
Recent Findings
Recent studies have provided additional data regarding the pathophysiology, indications, outcomes, and costs associated with the treatment for Dupuytren contractures, emphasizing the importance of early diagnosis and intervention to preserve hand function and enhance quality of life 2, 1.