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Long Island Doctor Develops Surgery-Free Treatment For Dupuytren's Disease

NEW YORK (CBSNewYork) -- The hand condition dupuytren's disease affects millions of people, including CBS2's own Dr. Max Gomez.

It causes a thickening and contraction of the sheet of connective tissue in the palms and fingers.

Dupuytrens often runs in families. Dr. Max's father suffered from it, as does his brother, and both of them underwent surgery.

Dr. Max, however, was able to avoid the delicate procedure.

"There's your cord to the ring finger and then a dotted cord over to the little  finger, and you can see the effect on the little finger here at this bend, just being pulled down," Dr. Scott Wolfe, the chief emeritus of the hand service at the Hospital for Special Surgery, explained, pointing out where the dupuytrens disease had formed some very hard, uncomfortable cords in Dr. Max's hand, almost like scar tissue that's starting to contract.

"And you can see that the finger does not fully flatten on the tabletop," Wolfe said. "So that would be an indication for some type of intervention to release that."

Intervention for dupuytrens can involve cutting the hard contracted cords, surgery to remove most of the cords, or a series of injections of an enzyme called collagenase.

"It dissolves collagen. The idea was to inject collagenese into collagenous tissues with the idea of breaking that tissue," Wolfe said.

The first step is using a local anesthetic to numb the area. Then, the very expensive enzyme, brand name Xiaflex, is prepared.

Wolfe carefully injects the enzyme, avoiding the important tendons just underneath the hard cords, then waits 48 hours to let the enzyme dissolve the collagen.

The surgical alternative was devised by a hand specialist, Dr. Larry Hurst, on Long Island.

"This is something that really has revolutionized the care of our treatment of this disease," Wolfe said. "I would say of all comers, 70 percent will now go for one of the less invasive modalities."

Then, the fun part.

Wolfe bends Dr. Max's fingers back to break the softened cords. Dr. Max says he can actually feel them pop in his hand. Then, he's fitted for a splint that he wears at night to prevent a recurrence.

In Dr. Max's case, he had to have the procedure repeated because the cord in his little finger didn't fully dissolve and pop. There's about a 30 percent chance of recurrence.

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