Revolutionary new treatment for crippling hand conditions

A SELF-EMPLOYED decorator whose crippling hand condition has made it virtually impossible to do the simplest of tasks has had his fingers straightened without the need for surgery, thanks to a revolutionary new treatment.

Michael Gascoigne, 68, of Bradway, has suffered from Dupuytren’s disease for the past four years – a creeping hand disease which causes one or more of the fingers to bend in towards the palm. The disabling disease, which eventually prevents sufferers from being able to control their fingers, is more common in people aged over 50, especially men. It is caused when thickenings develop under the skin, resulting in lumps in the palm and fingers, and often runs in families.

Now he is one of the first people in Yorkshire to benefit from a revolutionary new drug, Xiapex, which avoids the need for surgery and a lengthy period of physiotherapy. The new treatment is being offered by Sheffield Teaching Hospitals NHS Foundation Trust at The Sheffield Hand Centre, based at the Northern General Hospital.

The Hand Centre at Sheffield Teaching Hospitals NHS Foundation Trust is the only facility in the Yorkshire and East Midlands region to offer the treatment on the NHS. 

The drug treats the lumpy tissue through a special enzyme, which breaks down the knotted areas which have formed in the palm of the hand. Patients benefiting from the Xiapex treatment attend two half-hour outpatient clinics after an initial consultation, where they receive four quick injections (three at the first visit, one at the second). The fingers are eased back into place at the second clinic visit. The alternative surgery can last anywhere from 45 minutes to two hours.

Michael said: “I’ve suffered with curly fingers for the past three or four years. I just started to notice little awkward things like I was putting my hand in my pocket and all the coins would drop on the floor. I’d avoid shaking hands with people, too, as I wouldn’t be able to let go. The treatment was phenomenally good. I was in the outpatients clinic for five to ten minutes and the next day I could straighten my fingers again. Job done.”

The treatment is currently being offered by Miss Gill Rose and Mr Stephen Bostock, specialist hand consultants at the Northern General Hospital on a trial basis – with around 20 patients benefiting to date. Studies show that two-thirds of people who have had this treatment could almost fully straighten their fingers again.

The Xiapex treatment is not suitable for all Dupuytren’s disease sufferers as a number of complex clinical factors including the position of the lumps, medications being taken, or antibodies may on rare occasions make the treatment ineffective.

Miss Gill Rose, consultant surgeon at Sheffield Teaching Hospitals NHS Foundation Trust, said: “We’re delighted to be offering Xiapex as an alternative to surgery for suitable patients. The injection allows patients to have treatment with similar outcomes to surgery but with more patients able to return to normal activities within a week or two. In severe cases this could mean the difference between patients resuming normal day-to-day activities in a shorter time span, with many avoiding lengthy time off work, stiffness in the fingers and extensive visits to the hand therapists for rehabilitation over a period of weeks. Surgery is still a very valuable option for the treatment of Dupuytren’s but Xiapex has added a significant step forward in the overall management of this frustrating disease.”