Had two vials of injections for ring and pinky fingers. Then one cord broke in pinky before I could have manipulation done yesterday. Doctor broke the other cord. No problem there but I didn’t realize my hand would be such a mess afterwards. Is this normal? Thanks.
I guess that's normal- I had briusing and bleeding myself and my hand was considerably swollen for 1-2 weeks. But eventually my hand recovered and was fine after 2-3 weeks. I am sure your hand will be OK!
Wolfgang, Thank you! I don’t remember my doctor saying to keep my hand up so that could be part of it. I’m black and blue up to my armpit. It’s looking better this morning.
It took about a month for my hand to heal. There were large blood blisters that turned some of my skin black and were quite painful. This prevented a splint from being applied, although I did physical therapy. In the end, my fourth finger is almost straight, but my pinkie finger is still curled under (as you can see from the attached photo).
I'm wondering whether it is worthwhile to get surgery for my pinkie? Any thoughts on this?
Mine looked similar. I first had Xiaflex and after recurrence NA. That worked to some extent, i.e. it reduced the extenson deficit from 45 to maybe 20 degrees. This I have been able to maintain with splinting and I am happy with the result. I avoided surgery.
Wolfgang
GailSusan:... I'm wondering whether it is worthwhile to get surgery for my pinkie? Any thoughts on this?
Mine as done about 5 years ago, there were no major after effects other than some slight swelling and a small skin tear, which healed quickly. You may have an allergic reaction to Xiaflex, what does the doc think? My middle finger is starting to contract a little now, which I had expected. I woul do the Xiaflex again if it continues.
After the first set of injections the doctor waited and did the manipulation a week later. Result was massive swelling and a lot of broken skin tissue.
Second time I had the manipulation done the day after the injections (Xiaflex only works for 12 hours on the tissue). I also kept my hands at heart height and used ice packs frequently. The swelling was gone after two days and no broken skin.
Avoiding the broken skin is an important part of healing from the Xiaflex injections and for being able to do the physical therapy and use the splints afterwards. According to my doctor, I wasn't exhibiting an allergic to the Xiaflex. I think my blood blisters were due to keeping my hand down below waist level for the 48 hours after the Xiaflex injections.
If I had it to do all over again, I would keep my hand immobile, at heart level. I would also make sure all my medicine caps were open (I broke one of the cords accidentally by trying to open a bottle of pain medication, the childproof caps are impossible to open without using both hands.) I would think through everything I had to to for the 48 hours after the injections and prepare for minimal movement of my hand (I live alone).
I think this would have made a big difference in my recovery and in the use of my pinkie. I could not use the splint they wanted due to the damage on my hand. It also limited my physical therapy. The first six weeks after the chord is broken is the optimal time for splints and physical therapy. After six weeks, scar tissue forms according to my physical therapist.
I didn't find this forum until after I had the Xiaflex injections. If we can share this kind of information and get the word out, perhaps we can help others to have a better experience and more success with the injections. I've seen them work for two of my friends. Their hands look normal and function perfectly. One did not even have physical therapy afterwards.
I've had two Xiaflex treatments this year: one in April and the other in early August. My right hand pinky and ring fingers were contracted. At the base of my ring finger were 3 or 4 prominent cords. My ortho surgeon recommended treating the palm cords with 1 vial of Xiaflex, then return a few weeks later for treatment of another vial directly into the little finger (my little finger was contracted 90+% by the treatment date in August). During the first treatment process my hand was swollen, black and blue, and I also had the occasionally-reported pain in that side's armpit from the lymph node receiving the Xiaflex residue. However within 2-3 days the armpit pain was gone and in a month the entire hand was healed. Then, in August, I submitted to the 2nd vial of Xiaflex, this time directed into the little finger exclusively. The reaction was 10-fold as far as pain, and especially the lymph node response. This time the entire area in and around my armpit turned blackish-blue and the pain was substantially greater. It took over a week for the discoloration to go away, but the pain--albeit more subdued--lasted at least two weeks, maybe longer. The swelling in the little finger went down to normal in 3 weeks, with the hand looking somewhat normal in about a month. In both treatments the pain was far greater during both the injections as well as the manipulation. The pain was further enhanced when I received billing for my portion of the procedures, exceeding $1600 (and that's being Medicare-insured with an Advantage policy!).
I told myself that if this process corrected the contractures for at least a year, I'd go through it again (I am a pianist and cannot afford to have any bent fingers).
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