wach:

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Siede effects after my Xiaflex were not very severe. I had major swelling, pretty much like Bruce describes on http://www.dupuytren-online.info/dupuytr...xperiences.html. That picture with both hands could be mine as well. I also had hematoma in the little and ring finger and into the palm. It hurt but not dramatically. Today, 10 days after the injection, the swelling is neraly gone as are the hematoma.

I have the impression that my PIP joint wants to return to the contracted position and I am still wearing a splint 15 - 18 hours per day, with breaks in between to keep my joints flexible, and I am exercising flexion. I have no idea how long the current result will hold or whether it might even still improve a little bit over time. Future will tell.

My personal concern with Xiaflex is that, once injected you can't stop it. If you missed the cord somewhat and the enzyme is leaking elsewhere you can't do anything about it. With NA when you are doing something wrong you just stop doing it. With Xiaflex you have to wait and see. But anyway, my PIP joint became fairly straight again and is now much better than before. That's what counts.

Wolfgangh

Hi Flora,

Thank you for your long post and advice. I certainly will consider all you said and get myself to Lankspur soon to meet with Dr. Denkler and get his opinion. I think very highly of Dr. Denkler and trust him, but every time I think I am ready to consider Xiaflex I come across a post like the one I just read here (see: today's post "Re: After Xiaflex"), and get really scared when others talk about bad reactions to the enzyme.

Except for my small fingers in both hands (my right one is very bent, my left one is barely starting to bend), the rest of the fingers are perfectly straight, and both hands lay totally flat with only nodules and dimples in both palms. There is some pulling of both thumbs into the palms, but its not bad and it doesn't interfere with my holding my brushes when I paint.

So I am very undecided...should I leave it alone until it gets worst? should I chance side effects and try the enzyme on the pinkies? One thing I wouldn't hesitate to repeat is the RT that I feel definitely stopped the progression of the disease in my left hand.

So many decisions....I really need to go see Dr. D.

re PIP contracture in the little finger and straightening agfter a procedure....
A hand surgeon told me that surgical correction (I guess this would apply to NA or Xiaflex as well but the discussion was about open surgery) was usually lost "to some degree" several months following surgery, and the way it was explained was that is was related to issues other than recurrence of the disease.

In other words, if I understood it correctly, surgery (or perhaps correction via NA or Xiaflex) would straighten the finger but, in most cases (not all), some of the correction is lost as contracture returns to the PIP joint of the little finger based on unique biomechanical issues with that particular joint. So the disease may or may not return in that finger but there it won't necessarily stay straight. Again, this came from one hand surgeon.

Physical therapy plays an important role for dupuytren patients. The physiotherapist do stretching with the application of heat and ultrasonographic waves which helps in Dupuytren contracture. Sometimes looking at the condition of the patient, the physical therapist may recommend the patients to wear a custom splint or brace to stretch the fingers further. Even performing the ROM exercises frequently relaxes the patients. And after the surgical correction of the contracture, physical therapist often take care of the wound, perform massage, passive stretching, active ROM exercises, and splinting.
Physiotherapy has become a an important tool of recovery for many diseases. The physical therapy involves the natural and fast recovery of dupuytren's contracture. The site has mentioned the complete detail about the work of physiotherapists. http://physicaltherapycolleges.org/ though physical therapy for Dupuytren's contracture consists of only gentle stretching and tissue mobilization techniques. Still it plays a major role in strengthening and mobilizing the fingers.

stephenjeffrey:

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LubaM.:

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I believe some of us are just prone to quicker recurrence. I might try Xiaflex in the future for the small finger that had NA twice, but I am a bit scared to do it in view of the many people who have posted complications with Xiaflex such as bad bruising all the way to armpits, etc... and yet others have been very satisfied and have not had major complications...go figure...

Can you direct me to posts or articles that mention this type of extensive bruising that reaches the armpit?
What are the patients Dr's saying has happened internally when presented with this ?

Thankyou