cindy850,

So are you against all surgery or just a minor surgery such as a fasciectomy? My fasciectomy was nine years ago and my hand is as good as before Dupuytren's. I only had two sessions of PT. Probably every surgeon who does NA would disagree with your assessment of fasciectomies. Most do both NA and hand surgery. Surgery is often the next step after a NA that doesn't work as well as expected. Also, many people like having all of their fingers.

There are several known problems with fasciectomies. The risk of severe complications including amputation is something that only results from this procedure and not from NA or Xiaflex. Recovery time is months and in some cases people find themselves a year later with less use of their hand (due to loss of muscle strength) than before the operation.
There are risks for the tourniquet and risks from the general anesthesia.

The only studies I could find regarding hand surgery and Dupuytren's suggested a recurrence rate of 50%. Out of a thousand patients there are likely to be some people who had full use of their hand after 60 days and after 10 years had no recurrence. But that is not information that you can extrapolate from to predict probable outcomes for different people with different surgeons and different physical therapists.

I do know that anyone who goes to 5 doctors, one who only does fasciectomy, one who does the fasciectomy and NA, one who does NA or Xiaflex, and one who only does Xiaflex, that you are highly likely to get 5 different opinions as to the best course of treatment. With the known risks of a fasciectomy I would want a second and possible a third opinion and even if proceeding with the fasciectomy I would want to find the surgeon who has the most experience successfully performing this operation. The doctors I would select for the additional input would be ones with extensive experience in NA and the use of Xiaflex regardless of how far I had to travel for the consult.