Dupuytren’s contracture after injection

What does an injection treatment involve?

In this treatment, an enzyme (usually collagenase) is injected directly into the thickened cord of connective tissue. The enzyme breaks down the collagen structure of the tissue, weakening it. This process takes about one to two days. After that, the doctor can carefully straighten the treated finger, causing the cord to break and the finger to return to a normal position.

The injection treatment is less invasive than an operation and can be carried out as an outpatient procedure. It is a popular choice for patients in whom the condition is limited to one or a few fingers and in whom the cords are clearly visible and accessible.

Please note: Kliniek het Bolwerk does not carry out this treatment

An injection treatment for Dupuytren’s contracture, such as with collagenase, falls under specialist care and is performed by hand surgeons or orthopaedic surgeons in hospital. Kliniek het Bolwerk does not perform this treatment. This information is intended to give a general explanation of the condition and the possible treatment options.

If you have symptoms that fit Dupuytren’s contracture or are considering an injection treatment, we advise you to contact a hospital or specialist with experience in hand surgery.

Recovery after the injection

After the injection and the straightening of the finger, patients may notice a difference straight away. The finger is straighter and the palm feels more supple. The recovery process is usually quicker than after a surgical procedure. There are, however, some important points to keep in mind:

• Swelling and bruising: The treated area may be temporarily swollen and tender. This is normal and usually subsides within a few days to weeks.
• Limited movement: For a few days the hand may feel somewhat stiff, especially after the straightening. Gentle exercises can help restore mobility.
• Wound care: If small tears have formed in the skin due to the straightening, these need to be cared for properly to prevent infections.

During the follow-up appointment, the doctor can further assess hand function and give advice on any additional treatments, such as physiotherapy.

Benefits of an injection treatment

An injection treatment for Dupuytren’s contracture offers various benefits, especially compared with a surgical approach. The main benefit is that the procedure is minimally invasive. No large incisions are needed and the recovery time is considerably shorter. Patients can often resume their daily activities within a few days. Moreover, the results are visible quickly, and for many people this means an immediate improvement in how their hand functions.

Aftercare and rehabilitation

Although the injection treatment is effective, recovery requires aftercare to ensure the best possible result. Patients are often advised to move their hand regularly and do gentle stretching exercises to maintain flexibility. In some cases a splint may be prescribed to keep the fingers in a straightened position and prevent recurrence.

Physiotherapy may also be recommended, especially if the fingers had been severely bent for a longer period. The therapist can suggest specific exercises and techniques to improve muscle strength and mobility.

Possible side effects and risks

Although the injection is a safe treatment, there are some possible side effects:

• Temporary pain, swelling and bruising at the injection site.
• Stiffness or a slight restriction of movement, which usually improves within a few weeks.
• In rare cases an allergic reaction to the injected enzyme can occur.

However, the risk of complications is much lower than with surgical treatments, and in most patients the injection leads to a considerable improvement.

Long-term results and recurrence

The effectiveness of an injection treatment for Dupuytren’s contracture is high, especially in the early stages of the condition. Still, there is a chance that the condition will come back in the future, as the connective tissue in the hand can keep changing. Recurrence is not unusual, but can often be treated again with an injection or other methods.

With proper follow-up and, where needed, additional therapies, patients can nevertheless continue to benefit for a long time from better hand function and straighter fingers.

Want to know more? Read more about trigger finger at Kliniek het Bolwerk.