Ok, well that part about losing a finger pretty much did it for me. Paula

In the article at the tiny url there is this statement

"Kaplan also described nerve injury as surprisingly low and added that no one reported temporary numbness."

I was in the III stage clinical study and reported numbness in my finger. It was temporary and it was minor (lasting about six weeks) - but I did have numbness - so Kaplan is incorrect in his statement.

Being averse to all thing medical. the fact that Xiaflex generally requires a minimum of two interventions vs. just one for NA is EXTREMELY off-putting. For me (and presumably others), Xiaflex would have to have some other major comparative advantage vis-a-vis NA to justify its use in lieu of NA . e.g. more effective, reduced risk of complication, lower recurrence rate, less expensive, less pain/discomfort, faster recovery, etc. From what I have gleaned thus far, Xiaflex offers none of these advantages.

Good point about the (potentially) wider availability of Xiaflex.

Excluding travel, my NA cost [only] around $700-800 which (fortunately) was reimbursed by my insuarance company.

The talk about losing a finger was total unfounded speculation, and from what I understand, a misleading exaggeration of what could happen even in a worst case. If Xiaflex was that destructive to all tissue, it seems like simply injecting it anywhere in the hand would be a disaster. I think it was not good journalism to include that comment. I'd also point out that Xiaflex is in trials for frozen shoulder, and if that finger loss was remotely possible, we'll be hearing of entire arms falling off. Somehow, I don't think that is going to happen.

The tendon rupture issue is more real. My sense is that to some degree, that happened simply because the procedure is utterly new. It would be useful to have the details of how they happened, and the expertise of the person doing the injections, and the injectionists narrative of what happened. Without that knowledge, it is very hard to reasonably assess and extrapolate about the future.

I also get a strong sense of conflicted interests in the reporting, especially from hand surgeons. It is, rather predictably, not surprising that some are busy building arguments aimed at limiting the use of Xiaflex to their specialty. If I were a surgeon doing a lot of old-fashioned fasciectomies, you can bet I would be interested in keeping as much of the business to myself as possible after the introduction of a new treatment.