48 hours after NA procedure with Dr. Denkler. Stage 4 on left pinkie, stage 3 on right pinkie. PIP release on both DIP on left.

After a few appointments with doctors in other states, phone calls and extensive online research I was pleased to discover Dr. Denkler. Most importantly his experience and success with stage 4 patients and his extensive number and varied patient history. In addition his willingness to publicly share all aspects of procedure, success rate and cost. His staff are also very pleasant at all steps of the process. I planned on driving from Phoenix and travelling on to Wyoming for a short period of recovery with family.

Procedure went very well. I had limited expectation on left PIP and DIP as I have left this hand go too long. However, while I am at just 48 hours the results are better than expected. Right hand extension is almost back to normal. Left will take some additional personal therapy especially on DIP (stupid me.) Didn't feel a thing during procedure which took only approx' 2 hours from consult to procedure.

Decided to drive on to Wyoming. While I felt no pain for a few hours the local began to dissipate and some pain kicked in (this I had expected.) In hindsight making a relatively long road trip after the procedure was not a wise decision. However, I was able to function over the travel period without safety issues (this is not a recommendation.)

Currently have moderate pain in PIP's and DIP waiting for discomfort to subside before flexing. Other than that no other issues.

While there are mixed results for NA over the long-term. I will do NA again probably with the addition of Xiaflex. Surgery was absolutely not an option. I am very pleased with the NA results.

Dr. Denkler, what can I say other than he comes highly recommended.

- Mark

I had Dr. Denkler perform NA on my 95 degree pinkie PIP contracture in November of 2006. Best medical decision I EVER made. Immediate release to about 15-20 degrees. Over time, the contracture has actually DIMINISHED to the point that it's virtually negligible. The doctor and his staff were outstanding in terms of support, bedside manner, logistics, administration, and medical result. I should qualify myself by stating that I am absolutely fearful of all medical interventions. Yes, there was considerable pain, per my standards, during the portion of the procedure in which the finger was injected repeatedly to provide anesthesia. The actual manipulation was painless. Given my PIP had been contracted for such a long period of time, Dr. D recommended PT with a hand therapist back in my home city. I completed the PT program in a few months, followed all advice with respect to splinting, particularly night splinting, which I continued for about 3-4 years, eventually tapering off to zero.

There were some minor complications in terms of swelling, numbness, and skin tearing, but these were painless, temporary, and WELL worth it in exchange for having a "normal" hand again after gradual but marked deterioration over a period of 6-8 years or so from the time that I first noticed a problem.

I do have other DD symptoms, most of which have developed in the ensuing six years. Most troublesome is a "slight" PIP contracture on my opposite hand pinkie, which I'm continuing to monitor.

If need be, I'll make the trek back to Dr. D when the time comes, despite the cost/hassle of flying up from LA to SF.

MikeS

Thanks for you feedback. Less swelling 72 hours in but still have pain on PIP and DIP (not as much as yesterday.) For as long as I had left my hands go I was amazed at the results. Other than swelling I'm doing good so far. Look to start more frequent and extensive manipulation over the coming days.

Mark

mstratfo:

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Hi Luba,
Good to hear you had positive results with Dr. Denkler.
I'm not sure whether I will seek PT. What is involved with PT beyond what I can perform myself with flexing and stretching, etc? I am looking into night brace options as I do have a boutonniere on the left pinkie and this finger looks to need extensive care to return to reasonable health. Yes, I did both in one session. The right pinkie was far less gone than the right.
Mark

96 hours in and pain and swelling have significantly improved. I can fully flex both PIP's with limited discomfort. DIP on left still tender. PIP on left also somewhat tender when attempting stretching as muscle memory is quite severe on this finger and initial PIP manipulation during procedure including attempted DIP release was quite aggressive. Continued happiness. Look forward to getting splint squared away.

- Mark

This is all very interesting because until I had a similar experience, I hadn't read about anyone having pain after NA. My PIP joints remained very sore for months and I still can't bend the DIP of one finger (I could before NA). I had NA with Dr. Denkler in January. The pain didn't go away until I had a cortisone shot last month and it still hurts a little if I try to make a tight fist (which I can't do). The hand surgeon told me it would take about 6 weeks for the trigger to correct itself after the shot but I don't see any progress yet. And after all of this, my contractures are back to where they were pre-NA. I'm not convinced that this is a good procedure for PIP contractures

Please continue updating on your progress. I'm anxious to hear that your fingers stay straight since I may give this one more try and see Dr. Badois in Paris while on vacation there in August. I hope you both feel better really soon.