I'm new to this forum, having researched Dupuytren's Contracture online since I discovered my condition and was officially diagnosed with DC approximately 18 months ago (I had assumed the "bump" on the palm area of my right hand below the little finger was a callous that just didn't go away).

I've had four visits to four separate specialists--three being ortho surgeons and the fourth an MD specializing in hand treatments including using Xiaflex--over the past year or so, and have differing views from each as to the efficacy of any treatment other than surgery (other than the MD who touted the benefits of Xiaflex). My most recent opinion was rendered by a young D.O.--a doc that is part of a sports medicine and ortho group--who cited the negative statistics involving the Xiaflex treatment including side effects and, specifically with my level of DC, the likelihood that since my "cord" was primarily located along my little finger (and since the little finger apparently has the most collagen anyway, due to its comparatively small size), the Xiaflex option would not be the best. He confirmed that surgery was the best option for my condition (about 20 degrees curvature, affecting the little finger only but a substantial node located below the base between the little and ring fingers). I am a professional musician (keyboardist) and the issue with me is not so much the curvature of the little finger but the increasingly limited span or stretching of my fingers due to the constriction caused by the cord running up my little finger.

I am guessing many/most of you have faced--in recent years at least--the option of either Xiaflex or surgery as a treatment option. Do any of you who have/had DC had it localized on your little finger? And if so, did you get any medical opinions concerning the use of Xiaflex as to the dangers or inefficacy it may pose due to the localization of DC being on your little finger?

I've read scores of personal opinions by DC patients who have undergone either (or in some cases, both) Xiaflex and surgery online, and there is an absence of clear and definitive evidence that one is clearly a better option than the other.

I am currently scheduled for surgery in a little over a month, with plenty of time to change my mind. I would appreciate any comments from participants on this site as to Xiaflex vs. Surgery, and especially from those of you who are inflicted with DC affecting mostly your little finger. Thank you.

Hi rockinroller

I think I would try either NA or Xiaflex ahead of surgery if at all possible, and I could find a physician with enough experience of performing them whose opinion was that one of those procedures was possible in your specific case. This usually means a distinct palpable cord that can either be cut or injected into. A large nodule and cord on the pinky affecting the PIP joint is always difficult to treat, even with surgery, so the minimal interevention option should be explored as a possibility first.

Best wishes SB

I had Xiaflex procedure done about 2 1/2 years ago and am extremely pleased with the results. With 30 degree contraction of my middle and ring finger, I was told 8 years ago I needed surgery and months of rehab but I couldn't take the time off from my job so I opted not to do it. When I heard about Xiaflex I decided to try it. I had full use of my hand a week after the procedure and am still able bend my fingers back over 20 degrees. There was some minor bruising, swelling and skin tearing but nothing major. Keep in mind that there are really no guaranteed "permanent" fixes for DC, sometimes a procedure will cause it to come back with a vengeance. The success of Xiaflex, or any procedure, depends almost entirely upon the skill of the doc. Whatever you decide. make sure you find someone who has done many successful procedures. Mine was done by a plastic surgeon who specializes in hands. I know for a fact that surgeons don't like using Xiaflex because it is not as profitable as surgery.