KNOWLEDGE BASE ARTICLE

Plastic surgery terms explained

Dupuytren’s contracture after injection

What does this term mean?

Definition

Dupuytren’s contracture is a condition in which one or more fingers gradually bend toward the palm due to thickening and shortening of connective tissue. This progressive condition can significantly impair hand mobility and function. One effective treatment option is an injection with an enzyme, such as collagenase, that breaks down the fibrous cords. After the injection, the affected finger can be gently extended, often improving hand function without surgery.

In-Depth Explanation

What does the injection treatment involve?

The injection treatment involves administering an enzyme directly into the thickened cord of connective tissue in the palm. This enzyme, most commonly collagenase, breaks down the collagen structure, weakening the cord over a period of one to two days. After this period, the physician manually extends the affected finger, allowing the weakened cord to rupture and restore the finger to a straighter position.

This procedure is less invasive than surgery and is usually performed in an outpatient setting. It is especially suitable for patients with limited disease affecting one or a few fingers where the cords are well-defined and accessible.

Recovery after injection

Following the injection and extension procedure, patients typically notice immediate improvement. The treated finger appears straighter, and the palm feels more flexible. Recovery is generally quicker than with surgical intervention, although some temporary effects are common.

Swelling and bruising may occur in the treated area and usually subside within a few days to weeks. The hand may feel stiff initially, especially following the extension. Gentle stretching exercises are often recommended to help restore range of motion. If small skin tears occur during the extension, proper wound care is essential to prevent infection.

During follow-up appointments, the physician evaluates hand function and may recommend additional support such as therapy or splinting.

Benefits of the injection treatment

Injection therapy for Dupuytren’s contracture offers several advantages over surgical options. The treatment is minimally invasive, does not require large incisions, and results in a much shorter recovery time. Most patients can resume daily activities within a few days, and improvements in hand function are often immediate. Because the enzyme specifically targets the fibrous cord, the surrounding tissues are usually preserved, making the procedure safer and less disruptive.

Aftercare and rehabilitation

Although the injection procedure is effective, aftercare is essential to maintain results. Patients are advised to move the hand regularly and perform gentle stretching exercises to maintain flexibility. In some cases, a splint may be recommended to keep the finger extended and prevent recurrence.

Physical therapy may also be beneficial, particularly for patients with long-standing or severe finger contractures. A therapist can provide targeted exercises and guidance to help improve muscle strength and mobility.

Possible side effects and risks

The injection treatment is generally safe, but certain side effects may occur. These include temporary pain, swelling and bruising at the injection site, and mild stiffness or restricted movement. These effects usually resolve within a few weeks.

In rare cases, an allergic reaction to the enzyme may occur. However, the risk of complications is significantly lower compared to surgical treatment, and most patients experience substantial functional improvement.

Long-term results and recurrence

The injection method is highly effective, especially in the early stages of Dupuytren’s contracture. However, since the condition results from ongoing changes in the connective tissue of the hand, there is a risk of recurrence over time. Reappearance of contractures is not uncommon, but repeated injection therapy or other treatment options can often manage the symptoms.

With proper follow-up and supportive care, many patients can enjoy long-term improvement in hand function and experience fewer limitations in daily activities.

About the author:

Dr. David Jairath

Plastic Surgeon

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