Hi flyfisher

I don't have personal experience of Xiaflex, but you are right we do hear some horror stories, but also many success stories, probably more in fact. I think the lesson to learn is pick a doctor who has not just done the training, but now has a few years experience of using Xiaflex in 100's of cases. Good luck for a positive outcome.

Is NA ruled out?

Regards SB

Flyfisher, if by "same condition" you mean mainly nodules in the palm and perhaps some retracted cords, NA/PNF should definitely be an option, and you may want to look into radiotherapy. I would run from anyone telling me I don't have options, unless I am missing information about your condition.

On the other hand, if you already have the Xiapex procedure scheduled and it doesn't cost you a fortune, the risks seem manageable and (unlike open surgery) limited to discomfort and pain. So if your doctor has the necessary experience, why not.

I had Xiaflex administered on my left hand by a US plastic surgeon in July 2014 and the results were amazing. Years ago, a hand specialist had recommended surgery but was employed at the time and really couldn't spend the long rehab. I'm glad I waited until I found a doctor who had experience with Xiaflex. I have full use of my left hand and the procedure was pretty routine, some pain involved in the injections but it was worth it. I have nodules growing in my right hand and if they develop into DC I will gladly have the same procedure done on that hand.

I have had the Xiaflex injections done twice and the first time it was done by a very experienced hand surgeon, Dr. Denkler using the then recommended guidelines from the manufacturer of the product. The Xiaflex was injected and then a week later the hand was manipulated and a partial NA performed on those areas where the Xiaflex was not enough. As the doctor has done more than a thousand NA procedures his skill was not in question.

The second time, two years later, when I again needed treatment for severe contracture I spoke with Dr. Denkler about changing the procedure and he agreed to the changes. The Xiaflex takes 12 hours to work and then stops dissolving more of the Dupuytren's tissue. So I had the doctor do the injections at 10 am the first day and the following day he worked my hand and performed a NA on the hand where the Xiaflex had not been enough.

With a doctor who has experience with NA and Xiaflex the two procedures can be done on those parts of the hand where it safest. The Xiaflex is safer around nerve bundles and the NA can be used for other parts of the hand.

The problem with the company that sells Xiaflex is that they will allow doctors with no experience with hand surgery to use its product after a short introduction. In my area the doctor practices sports medicine and I was not going to have him do the procedure. I traveled to Dr. Denkler's office to get the best practices and best results.

Two years later my left hand is still in great shape and it was the use of Xiaflex and NA by a skilled and highly experience hand surgeon that made all the difference in the world.

Hi all , I go in on Monday 29th , late afternoon for the injection then early Wednesday 2nd for the manipulation . I am more than a bit concerned , especially all the problems I had after the operation on my left hand as I still have a lot of scar tissue , and one large nodule returning . I always said "I am not going through that again with my right hand" . However , my consultant basically told me that I have little choice with my right hand as " doing nothing is not an option " . At the time of the operation on my left hand Xiapex was not a treatment as it was not funded by the NHS . Trying to remain positive is difficult !!