DD is often activated by trauma and surgery is trauma, as is NA. I don't know the stats, but perhaps half of the surgeries are good outcomes and the other half problematic -- disease accelerates. That's one reason I think NA might be better, much less trauma.

Yes the DD is still active and has calmed down with rest, managing it is key. My Xiaflex dr was in the studies for the protein that breaks down only the build up of collagen that causes contraction. Before surgery it was inactive. And yes surgery 3 years ago made DD go into a huge flair. Started only with one pinky slightly bent no problem for me at the time & hand still useful.

The hand surgeon said I must have surgery on DD then to cut out the collagen area. That set off a chain of events causing the 4, & pinky fingers to begin to contract to the fist. Could not use my hand as the third finger began to twist to the side. All the tiny nodes in my palm that were there for 20 years began to become active and larger. No cords had formed.

The lesson...as stressed on this forum, surgery is the LAST alternative for DD,as it sets off a chain of events. DD becomes
active. Even when wearining a splint at the time I could not stop the fingers from contracting.

Even other treatments can set off DD. See alternative treatments and when to apply surgery on this forum. There are different stages of DD with different treatments. This is the most knowledgeable and effective forum for up to date treatments online.

THe Xiaflex dr was discusted that the surgeon from a well known teaching hospital university with all the latest would actually perform surgery in the first place, then ignored me and would not give me the common curtesy of any referrals after the fact. He just spinned on his heels and left the exam room stating well you had a flair. Wouldn't answer my phone calls.

I found Xiaflex on the internet before I found this forum. This forum has a wealth of knowledge. Do research before you decide on any treatment. Everyone is different. Xiaflex opened the fingers. They are not perfect but I can use my hand & fingers and that's what counts.

Good luck to you.
Kind Regards

Most hand surgeons have no experience with Xiaflex or with NA and very few have experience with both. They do have a lot of experience with performing a fasciectomy so they can do that and not lose a patient/customer and they get paid a lot more for this operation for the hour involved than they get paid to do a Xiaflex or NA procedure.

Best to find a hand surgeon who has experience with all three procedures and who therefore can judge what will work for you. I found the best results came from having the Xiaflex injections on the first day and then NA performed on the following day. NA is fast and effective but risky where nerves are located.

A major source of permanent injury from fasciectomy is that a tourniquet is applied and there is no blood flow to the hand and its tissue and nerves for an hour or more. There are alternative approaches but surgeons as a whole are the least likely group within the medical community to change their "tried and true" approaches in the operating room.

The surgeon is also done with you after you leave the operating room. Any post operative problems are not their concern, only perhaps of their insurance company. They have no incentive to change what they are doing so as to provide for a better outcome or reduce the recovery time for their patients/customers.