What injectable therapy is used nonoperatively for Dupuytren's contracture?

• A. Steroid injections
• B. Collagenase injections (Xiaflex)
• C. Hyaluronic acid injections
• D. Platelet-rich plasma

Answer: (B)

Nonoperative management of Dupuytren's contracture can be achieved with collagenase injections, specifically collagenase clostridium histolyticum (Xiaflex). This injectable enzyme dissolves the collagen in the Dupuytren cord, weakening it so the finger can be extended with a controlled manipulation, thereby releasing the contracture without surgery. It’s a targeted, minimally invasive option that directly addresses the fibrous cord causing the bend, offering an alternative to fasciectomy for suitable patients with palpable cords and MCP joint involvement. Other injections like steroids, hyaluronic acid, or platelet-rich plasma are not used to treat the fibrous cords in Dupuytren’s and don’t provide the same enzymatic breakdown needed to release the contracture.