| Recurrence ...post xiaflex injection |
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02/17/2012 08:16
richardt 
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02/17/2012 08:16
richardt
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Recurrence ...post xiaflex injection
Had a Xiaflex injection last April as part of clinical trial studying the efficacy of Xiaflex in thumb webbing. Injection administered by physician at Indiana Hand and Shoulder Center. All went well. Gained about 15-20 degrees in the web space, thumb to index. Xiaflex broke the internodule band between the 2 extant nodules and allowed greater range of motion in my thumb. Now some 10 months later, the contracture is back to where it was pre-injection. The nodules (now 3) have grown and a new band formed where the old was. Oh well, back to skin grafts.
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02/17/2012 19:33
flojo 
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02/17/2012 19:33
flojo
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Re: Recurrence ...post xiaflex injection
Although I would consider Xiaflex, I really don't see any reason not to do NA instead. I've had NA on the same hand 2 years apart and it is so simple and recovery is very minimal. Cost is much, much less. I may need it again in 2 years, but wearing a night splint seems to be helping a lot.
Think about the NA option.
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02/17/2012 19:48
callie
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02/17/2012 19:48
callie
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Re: Recurrence ...post xiaflex injection
What happens to the cord in both Xiaflex and NA? Does it dissolve, or still there?
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02/18/2012 07:18
wach  Administrator
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02/18/2012 07:18
wach Administrator
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Re: Recurrence ...post xiaflex injection
With NA the cord is broken mechanically. It is still there but the finger can be stretched. With Xiaflex the cord is damaged with the collagenase and then broken mechnically ("the manipulation"). It also remains in situ. The collagenase may dissolve a little bit of the cord (which consists of collagen) and it may change the mechanic properties of the cord (it might become softer and more elastic).
Wolfgang
callie:
What happens to the cord in both Xiaflex and NA? Does it dissolve, or still there?
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02/19/2012 05:45
flojo
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02/19/2012 05:45
flojo
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Re: Recurrence ...post xiaflex injection
Dr. Denkler described Xiaflex as dissolving or eating away (forgot his exact word) a little of the cord and it is less likely to grow back together. With NA it can grow back together easier because it only breaks it. That's why I think the night splint helps. Maybe it will keep it from growing back together altogether, or at least stretch the time between needing NA again.
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02/19/2012 15:04
callie
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02/19/2012 15:04
callie
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Re: Recurrence ...post xiaflex injection
Are nodules/dermal pits left in place with both NA and Xiaflex? Will they go away when the cord is broken?
Edited 02/19/12 22:57
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02/19/2012 23:49
flojo
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02/19/2012 23:49
flojo
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Re: Recurrence ...post xiaflex injection
All reduced by RT, but I have nodules and its. NA only works on the cords. My palm looks like bubble wrap (sealing that description again.)
NA doesn't help nodules, but I think it's the cords are what contracts. Right?
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