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Xiaflex® is an injectable form of the collagenase enzyme used by clostridium bacteria to digest collagen. When injected into a Dupuytren’s cord, the enzyme dissolves the collagen fibrils at the site of injection. This creates a weak spot in the cord, such that it either ruptures on its own, or is easily ruptured by the physician at a subsequent doctor visit. Collagen is also present in many other important structures of the hand, including the tendons that move our fingers, so it is important that trained professionals inject it directly into the cord, and not anywhere else. Success after an injection procedure has been defined as correction of the joint contracture to 5 degrees or less. While these rates vary according to how severe the contracture was beforehand, 50-75% of joints were treated successfully in the large CORD I and II trials. Recurrence of joint contractures seems to happen with any treatment, and has been observed in roughly half of Xiaflex patients within five years of treatment. Complications of Xiaflex injection most often include pain and swelling, as well as minor skin tears, and very rarely include more severe inflammatory reactions, and damage to the tendons or other structures in the hand.

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