It's been about 4 months since I had the Xiaflex injections. As part of the procedure follow up, they say to wear the night splint for 4 months. Which I've been doing rather diligently. But, after a pretty short time upon awakening and taking it off, my ring PIP contracts from about 5 degrees to maybe 10-15 degrees. My MCP contracts to about 5 degrees. If I don't keep exercising throughout the day, it becomes very painful in the center of my palm to straighten out my hand, particularly when the splint goes back on at night. The pain subsides rather quickly, which is good. Then the process begins all over again the next day. I'm disappointed that I still have this degree of pain, and the general arthritic-like achy-ness and stiffness throughout the day four months post Xiaflex. Is this typical?

I'm also wondering..... How long should I keep wearing the splint? I feel like I'm not ready to abandon it, because it's the only thing that's maybe keeping my hand from contracting again, but four months have come and gone, and I still find the need to keep this up. Again, is this typical?

This is getting old.... ~Diane

In my opinion, wearing a night splint is crucial. I had NA for a mild to moderate contracture and did not get a splint the first time. 2 years later, contracture had returned at about the same severity. I then got a splint and wore it every night for over a year. It got straighter than right after NA. Then I'd skip some nights, but I still wear it 3-4 nights a week.

This is not scientific, but I think the splint pushing against Dupuytren's keeps Dups at bay and either it gives up or your hand gets stronger. I expect to have to wear it periodically for the rest of my life. I watch and pay attention to how my hand feels. If it feels like it's getting a little tight, I get diligent again in wearing my splint. My hand gets back visibly straighter with wearing the splint.

It might be a nuisance, but if your activities allow it, I'd say wear it as much as possible throughout the day, too, for about 6 months and see what happens. What your hand seems to be saying is that it needs the help of the splint to resist Dupuytren's pull. When you take it off and it immediately contracts 5 degrees, then is really tight when you put the splint back on at night, then settles down after you have the splint on for a while, it's working just like it is supposed to do. It's doing it's job.

Once the Dupuytren's gets the upper hand (oops, pun), it's too late for the splint to help and you'd have to have another procedure. I think it's the same idea getting teeth straightened and wearing a retainer. If the retainer is not worn every night, it feels tight when put in again. It doesn't take long for the teeth to shift back and the retainer can no longer fit in the mouth.

Don't quit on wearing the splint for AT LEAST a year is my opinion.

Anybody have luck with constant stretching after NA?

cschieber:

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I wore night splints for 6 months after NA and they didn't stop the PIP joints from contracting again. I stopped wearing them when the contracture was back to pre-NA level. If the splints are still working for you, I'd continue to wear them. They may be helping to keep your fingers straight.

I WOULD ALSO SUGGEST GET THE RIGHT TYPE OF FITTED SPLINT ..
I WENT TO A C.H.T. WHO DESIGNED MINE ...AND I GET NEW SPLINTS EVERY YEAR ...
WEARING SPLINTS ON BOTH HANDS AT NIGHT IS A PAIN BUT I DO IT ...AND THE RESULTS ARE WORTH IT ..

cschieber:

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Had my splints made by CHT and they were very comfortable. I had no trouble sleeping with them at all. I'd wear them forever if they kept my fingers straight. Sadly, they didn't help.
So what do you do when you have repeated NA procedures and they only last 6 months?

Edited 07/22/13 04:09