FWIW: My NA experience (Dupuytren’s) - left small finger PIP ~35°

Clinical brief (pre-procedure)

Primary issue: Left small finger PIP flexion contracture ~35°, partially correctable; positive tabletop test
Other findings: Palmar cords; left thumb oblique cord
Prior treatment: None (no surgery, no collagenase/Xiaflex)
Goal: Regain extension with a minimally invasive option (NA)
Age: 55

History: My small-finger contracture progressed aggressively over ~18 months prior to treatment.

Why I chose NA vs. Xiaflex vs. surgery
I chose NA based on my read of the tradeoffs: effectiveness (especially for my stage), risk profile, downtime, and cost.

Major-institution hand surgeon consult (U.S.)
Options offered: Xiaflex, open surgery, and (surprisingly) amputation.
NA was not offered in that office.

Xiaflex (collagenase) – what I was told

Risks discussed: including rare but serious issues like tendon injury/rupture (the way it was explained to me was “the tendon could be affected”).
Recovery: days (with bruising/swelling expected).
Estimated cost quoted to me: $14,000–$21,000 (breakdown given: ~$13,400 for Xiaflex + ~$600 for injection procedure; total dependent on billing/coverage).

Open surgery – what I was told

Risks discussed: infection and neurovascular/tendon injury (general surgical risks).
Recovery: weeks with therapy/splinting.
Estimated cost quoted to me: $5,000–$15,000 (again dependent on billing/coverage).
NA practitioners (U.S. and Europe) – what I found

NA (U.S. practitioner)

Risk discussed: low overall; nerve irritation/injury was specifically mentioned (I was told roughly “~0.5% chance,” though exact rates vary by series and definition).
Recovery: 2–3 weeks to settle down, then ongoing remodeling.
Cost: ~$1,500.

NA (Europe practitioner)

Similar risk/benefit framing.
Cost quoted to me: ~€400.

Outcome (my experience)

I chose NA with a U.S. practitioner.
Practitioner used local anaesthesia injections.
Range of motion improved a lot in my little finger and thumb.
I experienced sensory symptoms consistent with nerve irritation/injury in the little finger (numbness/tingling/sharp pain on impact).
At 6 weeks, sensation has improved somewhat, but I still have residual symptoms and expect it may take several additional months to see more significant recovery.

Notes

This is just my experience and the quotes/costs I personally received - pricing and options vary a lot by provider, region, and insurance.

Edited 03/23/2026 19:55