Hi,
Im new to this forum. I have aggressive DD in both hands. I have had 6 Xiaflex injections now in both hands. I also had open surgery on left pinky/palm 16 years ago and NA 4 years ago in both hands. My first Xiaflex injection was in the left little finger, it was contracted almost into my palm at this point and I had no release after the first Xiaflex injection but did have a release after the 2nd injection, and a big split in my palm opened when it popped, but it was straight. My right hand responded really good to Xiaflex which broke all my cords and they havent grown back much in the last year. My left little finger responded well to the 2 injections, but my left ring finger didnt release after 2 injections and I had to take a break after having 6 injections in 1.5 years. ALL of my manipulations have been very painful. Some injections are almost painless, others have been very painful for 8 hours after the injection, with my hand swelling to double size and bruising badly. Seems the more pain I feel after the injection, the better results when I get manipulated? The area around my injection is way to painful to be manipulated the next day. My Doc waits 1 week. He injects Lidocaine in my wrist area to numb my hand, but it never seems numb enough, because when he straightens my finger to break to cord it's very painful, even though the pain subsides within a few minutes, but it is severe enough that I had to stop after 6 injections even though I need 1 more cord popped. It's just very hard when I know what to expect and know the level of pain I will have to tolerate during the manipulation. When I had NA, I couldnt feel a thing as I was poked and prodded and straightened. But NA isnt covered by my Insurance, Xiaflex is, as well as open hand surgery, but I went the open surgery route and my Dup started coming back before my stitches were healed. It's been 5 months and I guess I am ready for more punishment, Im going back for another Xiaflex injection, this time I might see if he will inject Lidocaine right into my cord area for manipulation cuz when my cords break, it sounds like a pencil being broken in half, a loud pop/snap and then like cloth being ripped as all the little cords/fibers tear...OUCH!!! It takes all my willpower not to rip his head off when he breaks those cords...Anyone else had very painful manipulations after Xiaflex? Tnx

You need to have your Dr inject the lidocaine by the injection site.Have them spray Ethel Chloride where they will be injecting.It will freeze the area and takes alot of the sting out.If you dont tell them,they wont do it.good luck.Dave

I dont have it for the injections with this Dr either.The Doc in Oklahoma used it for both.He was very aggressive, 2 full shots of lidocaine.swelled your hand up big time.This Dr is more patient friendly. :).Dave

Many insurance companies are following the lead of Aetna Insurance.

"Aetna considers percutaneous needle aponeurotomy (also known as percutaneous needle fasciotomy) medically necessary for the treatment of adults with Dupuytren's contracture with a palpable cord."

http://www.aetna.com/cpb/medical/data/800_899/0800.html

Hi all, what a year it has been for me. Soon after my last post in April, I started having severe gut issues and ended up having a tumor removed from my colon, they had to fully open me up, bigtime incision down my belly, tumor hadnt grown outside the colon so all is well. Completed all my follow ups and now back to my DD. I made a Dr appt to get some more Xiaflex injections. Not to inject politics into the mix, but im not sure how the new ACA will effect me and want to get some injections done this year. Has anyone heard of waiting 1 year after major surgery to get Xiaflex? My old Dr mentioned he wanted me to wait, but my new Dr doesnt see a problem and my gut surgeon never heard of Xiaflex so deflected advise back to my hand Dr.
On a good note, my right hand has stayed pretty straight, my ring finger had the best results. I can still feel the cord has not reconnected, most other fingers have cords or bands, but very little.
I have developed lumps on my thumb tendons, but zero contraction, just discomfort.
Glad to see so many others getting Xiaflex. And yes, I have heard of the full graft operation, but I dont think I have the time it takes for recovery, sounds like I would need to take a 1/2 year to a year or more off work and I cant see that happening. I had a hard enough time being off from 8 weeks with my gut surgery, still feeling the pain from not working for so long.
Thanks for all the replies, you all have been very helpful. I look forward to visiting this forum in the future.