How many lawsuits have come from Xiaflex injection for Dupuytrens contracture?

How do I find out how many lawsuits have come from the Xiaflex injection for personal damage?  The injection caused great harm and damage to my finger….including necrosis.


Sorry to hear of your bad Xiaflex reaction.

Unfortunately, as the use of Xiaflex for treatment of Dupuytrens cords is becoming more common I receive more and more stories like yours from people who call or email the Dupuytren Contracture Institute.  I hear exactly the same type of story in which I am told about permanent injury to muscles, joints, nerves and blood vessels resulting in permanent loss of function, loss of feeling, terrible pain, varying degrees of weakness and tissue destruction, and sometimes eventual amputation.

It is never clear from the information I receive if the fault lies specifically with the Xiaflex drug that is used or with the doctor who performs the operation.   Most of the time these people who come to this website are looking for conservative options after more aggressive drug and surgical treatment have caused them apparent injury.

Another real problem concerning Xiaflex injections is that they have a high rate of Dupuytren recurrence, meaning that it does nothing to correct the actual Dupuytren contracture problem since the contractures, nodules and cords come back in about two to three years for about 80% of the people who undergo this procedure.  So after all these people expose themselves to the risks of injury (such as you have experienced), the only thing they can count on afterward is perhaps to from the problem only temporarily.   To my mind it is not worth the great risk for such temporary relief.   If you wish to read more about Dupuytrens treatment with Xiaflex, please go to “What is Xiaflex and what the risks if I take it?” from the DCI website.

I have referred to Xiaflex injections as surgery, although in the advertising that is done for this drug it is stressed that injecting this drug is a “non-surgical option for Dupuytren treatment.”  I do not agree with that statement and many others in the medical profession also see it as a surgical procedure.  The skin is broken with sterile medical equipment while  sterile technique is used, treatment of a medical problem is attempted, the procedure must be performed by a medical doctor with special training, it can take anywhere form 20-60 minutes to perform, and thousands of dollars are involved – sounds to me like it is surgery.  It is only called a non-surgical procedure to minimize and eliminate  patient resistance to the procedure, making the idea easier for the doctor to “sell” to the patient.

I have no idea about the number of lawsuits pending for Xiaflex surgery that has gone bad.  I suppose a good attorney would have that information for you.  The medical and pharmaceutical industries do not have a good reputation about how they handle drug reaction problems or doctors who hurt patients; they have been known to hide this information for reasons of protecting heir own profit without regard to patient safety and welfare.   Good luck with your hand.  TRH

27 thoughts on “How many lawsuits have come from Xiaflex injection for Dupuytrens contracture?

  1. Steve McEachern says:

    I had one injection of Xiaflex on a Wednesday for my Dupuytren’s contracture, and most of normal reactions. Swelling in hand began to subside on following Monday. I had a large bruise about 2″ wide inside same arm that went from elbow to shoulder-very dark purple, then yellow, now gone (about 1 week total). My wrist on same side also showed bruise about 3″ square area. Worst of all, I had an extreme back issue in an area where I have degenerative disc disease (L-4). I have lived with back episodes since age 15, now age 64. I have never experienced this extreme back pain, was taken to hospital via ambulance, when pain became so strong I could not move. I did help pick up a piece of steel on Monday, nothing unusual or extreme, then I had usual sore back until Wednesday AM, when I awoke and could barely get out of bed. I had to go to the floor, then work my way onto my feet,I could not turn, lean forward or backward or twist, lift anything, Tried ice pack, double dose Tylenol 3 with codeine, biofreeze. Finally became totally immobilized due to intense pain, called 911, went to ER, several muscle relievers and pain shots, came home and am taking medication now.In my adult life, I have never experienced anything near this intense. I wonder if the Xialfex for the Dupuytren’s contracture softened/weakened the tissue between the disc in my back enough to cause this problem.

    I would like to hear if other chronic back patients who suffer milder problems same as I do every six months or so had an extreme reaction. Are there others with chronic bone/nerve connectivity issues who also had extreme occurring?

    It seems plausible because of the reaction up my arm that the drug also could be carried from my palm lumps into other parts of the body, weakening tissue.

  2. Linda Angle says:

    Here is what happened to me and my Dupuytren’s contracture. I had a hand specialist inject xiaflex in 5 different areas of my left hand & fingers! FDA recommends for Dupuytren’s contracture only one injection one cord!! Then came the aggressive manipulation that ripped open all 5 areas of injection! FDA recommends passive manipulation! My hand looked like a pit bull chewed it up. I have constant varying levels of pain, burning, swelling and now have two fingers with boutonniere deformity! I can lay my hand flat on the table now! GREAT!! I can’t make a fist & my left ring finger & pinky finger only bend at middle joint! I am clearly NOT better off and wish I would have left it alone!

  3. Maria says:

    My husband had the xiaflex injection on his left hand for Dupuytren’s contracture. His hand has been swelling and painful. Can not wear his wedding ring. The Dr said make your ring larger what an SOB. His name is Dr.XXXXXXX in Orange Park Florida in Fleming Island. He should be kicked out of the medical field. He messed up my husband’s hand. His wrist also hurts now. His shoulder too. Hand still swelling and it has been a year since the Xiaflex injection. Trying to convince my husband about going to a lawyer to get this Dr. I am on the medical field and this Dr is an SOB.

  4. dennis schwartz says:

    i just wanted to say i have had the injections in my left hand and now wish i had not due to pain in the hand and joint damage lost of strenght nerve pain after 5 months and get worse doc ,s have no answer just say its the normal i say bull thanks for looking

  5. Paul says:

    I have had nothing but problems since my injections of Xiaflex for problems in my right hand. I had the choice but, thought because the Dr. made it sound like this would resolve my problems with the least amount of time it would be the best for me. When I was injected into the cord with Xiaflex it did hurt pretty bad but I got through it, two days later when I was injected with the numbing agent there was so much pain! felt like the Dr. pushed the needle right through my hand and I yelled pretty loud! . I have gone through therapy for many months on my hand and it has been 7 months and still can not make a fist and very little grasp strength in my right hand. The pain in my hand has been extreme most of the time since the injections. I just saw the hand Dr. again and he says the problem now is arthritis. I think this is not the problem as I can barely bend any of the fingers. I have had major back pain for many years and since the injections it has got worse and wondering if the injections in the hand could have caused me more problems. Even with all of the problems I have had with the right hand my back pain has been so bad and have been trying to get my back also fixed. I have been seeing a back doctor and he put me through physical therapy, aquatic therapy and all it did was make me hurt more, then when the back Dr. suggested injections in my back, I was not thrilled but wanted to end the pain so I agreed. When he tried to do the back injections I screamed as the pain was so bad. He told me he had to not continue as there must be some kind of muscle issue. I am wondering if this has anything to do with the hand injections. I have had nothing but worse pain in the hand and back since the Xiaflex injections and of course the hand doctor will not say there maybe a problem with what he did. Dupuytrens Contracture is a Disease and can affect your life but I do not feel the Xiaflex injections are worth the risk!!

  6. Debbie says:

    Hello, I have had a bent pinkie finger from Dupuytren’s contracture for a few years, now so I saw a hand specialist. The Dr told me about Xiaflex after having so much trouble getting the procedure cleared through my insurance I had the injection. The first visit the Dr injected a small needle to numb the site around the Dupuytren’s contracture nodule and cord then injected the Xiaflex in the finger. I came back the next day to have the manipulation done I could barely breath the pain was so bad I at 57 was crying . The Dr gave my wrist a block and the pain subsided . He said that he was unable to get my finger to bend back. On the third morning I woke up to a hand that was black and blue with unbelievable pain. Where the injection was I had black blisters going up my ring finger the bruising continued up my wrist into my arm . I called the Dr and he said it was a bad reaction. Now some 30 days later my finger is hanging out worse than ever when I just had my Dupuytren’s contracture, and there is a circle of red around the finger joint and when you touch it I about die! My ring finger is also still bruised my hand is weak. This by the way is my dominant hand . I was thrown back into hot flashes and mood swings , my bad back and shoulder indeed became much worse ! No one should every take the chance of such a horrible surgery !!! The Dr has refused to return my calls I have call the FDA on this terrible drug.

  7. Dr.Herazy says:

    Greetings Paul,

    After reading so many reports about problems after Xiaflex injections (I have gotten hundreds more like yours and worse), I have to conclude that they are not the cure for Dupuytren’s contracture people were hoping for.

    So much of the success of a good Xiaflex injection seems to be related to the way it is given – to the ability of the doctor to put it EXACTLY where it needs to go into the Dupuytren’s contracture tissue only, and no where else. This is proving to be a difficult problem. Even during those several years of the much discussed Xiaflex trails there were many reports of bad reactions due to the collagenase (Xiaflex) being injected into the wrong areas in a hand. Even the select group of famous doctors who were used in those trials were having problems. But there is evidence that many of these bad reports were never included in the Xiaflex trails and so the drug was approved. Today the drug is being administered by thousands of doctors who are not very skillful or accurate in putting Xiaflex where it belongs in the Dupuytren’s cords, and bad things are happening as a consequence. The average MD who has an office down your street is just – well – average, and that means his or her skills might not be sufficient to do a good job with Xiaflex injection. Beware. TRH

  8. Dr.Herazy says:

    Greetings Dennis,

    What a Dupuytren’s contracture double whammy: 1. You are one of many people who has a bad reaction to your Xiaflex injection. 2. The MD who did the procedure shrugs off your bad results and acts like it is no big deal.

    Really, I think the MDs are surprised at how bad Xiaflex reactions are for so many people with Dupuytren’s contracture. Many of them do not know how to explain to people the terrible results they are causing. I know it sound crazy, but I think the Xiaflex use continues only because it is a profitable Dupuytren’s contracture procedure and there is nothing else to replace it. TRH

  9. Dr.Herazy says:

    Greetings Maria,

    Sorry to hear about your husband’s bad experience with Xiaflex injections for his Dupuytren’s contracture. Many people are having such a bad reaction to this drug as you describe.

    I had to scrub that doctor’s name from your posting because it is not fair to hammer him this way when he has no way to defend himself. Not saying you are wrong, or that he is right, just saying this is not the way or the place to get personal. It sounds like you have other ideas in mind with what to do with that doctor. Good luck to your husband with his dupuytren’s contracture. TRH

  10. Dr.Herazy says:

    Greetings Debbie,

    You poor kid! Besides having to put up with the Dupuytren’s contracture, you now have a hand that is worse than what it was before the Xiaflex debacle. I suppose these Xiaflex injections do help some people, some time, in some ways, otherwise why would it still be on the market after hearing all these horror stories? I just never hear about anyone who has had a good reaction or is happy with the results. On top of these kind of bad reactions, it is also coming out that Xiaflex has the worse recurrence rate of all the medical treatments for Dupuytren’s contracture; this means the Dupuytren’s contracture comes back faster and sooner after the Xiaflex procedure than after traditional hand surgery.

    I have had people who were having post-Xiaflex reactions like you describe try to use Alternative Medicine treatments following the DCI concepts. Some of them do very well, others get only a little help, and a few no help at all. I mention this because you will have to do something to get some relief from your hand lumps, and more Dupuytren’s contracture surgery might not be the way you want to go until you have first tried a more conservative form of treatment. TRH

  11. Dr.Herazy says:

    Greetings Debbie,
    No one believes that this kind of thing can happen with a drug and procedure that is approved for Dupuytren’s contracture surgery. I hear this often each week. Bad reaction after bad reaction. I suppose there are some people who are happy they have the Xiaflex procedure for their Dupuytren’s contracture, but I never run into them. I guess it all comes down to how difficult it is to get that collagenase enzyme ONLY into the abnormal and fibrous tissue of the Dupuytren’s contracture and not into the normal and healthy tissue. This is why so much of your hand and arm tissue is reacting this way. You had enough of a problem just dealing with all the problems of having Dupuytren’s contracture. I am glad you called the FDA – more people should do that. TRH

  12. Dr.Herazy says:

    Greetings Steve,

    I have heard several stories like yours when Xiaflex is used to treat Dupuytren’s contracture. All stories have the common thread that other parts of the body, especially the back, react badly with pain, spasm and inflammation way out of proportion to their usual response after receiving Xiaflex (collagenase). When I first started to hear this pattern develop I thought it is almost as though Xiaflex somehow migrates to areas of old or chronic injury and weakens the tissue, precipitating an acute episode for no obvious reason. Another possibility occurs to me: The chronic arthritis or related soft tissue problems that are sites of these exacerbations might be more sensitive and overly responsive to Xiaflex in ways that have not been studied or determined. As is always the case when a new drug is used for a desperate problem like Dupuytren’s contracture, the people who are first in line are the guinea pigs who suffer the most.

    I have observed during these last few years while Xiaflex is still being used that most of the bad reactions occur for Dupuytren’s contracture when either too much Xiaflex is injected so that the excess pours out into the surrounding tissues and destroys them, or an unskilled or hasty doctor simply misses the target tissue and injects the Xiaflex into normal hand tissue where the results are the same terrible kind of tragedy.

    You might want to read more information on he Dupuytren’s Contracture Institute website about Alt Med use to reduce your fibrous tissue. Natural healing is a possibility that many are using. TRH

  13. Dr.Herazy says:

    Greetings Linda,

    You paint a vivid and gruesome picture of what can happen when Xiaflex is used to treat Dupuytren’s contracture. What is even more unfortunate is that your experience is not an isolated case. Did the MD who injected the Xiaflex into your Dupuytren’s contracture tell you that any of this could happen. or where you told that none of it? Anyone with Dupuytren’s contracture who reads these kind of reports should take caution. Better to have first tried a more conservative approach first with Alt Med before taking an extreme step like this. TRH

  14. Linda Genovese says:

    I have had 4 Xiaflex injections for Dupuytren’s disease in both hands & awaiting one more injection in my right hand
    I can honestly say that xiaflex has been a miracle procedure for me. My left hand was closing & now completely flat
    Yes I have lost some strength in my hands but minimal & now able to use my hands normally. Sorry to read these distressful results from other Dupuytren’s contracture patients. I have had no recurrences so far. Xiaflex is far less invasive than surgery.
    I would absolutely recommend Xiaflex injections, but only by an approved hand specialist.

  15. Dr.Herazy says:

    Greetings Linda,

    Thank you for your report concerning your Xiaflex injections for Dupuytren’s contracture.

    As I have said before on this website, there must be some people who have good results from Xiaflex injections into their finger cords and palm lumps, but we do not hear from them. Most people come to this site looking for help or answers after their surgery or Xiaflex injections has failed them or gone badly wrong. For this reason our DCI website collects many sad stories of Dupuytren’s contracture surgical failures. It is good to get your positive response since it tends to balance things out for our readers. Thank you for that.

    You mention that you have already had four Xiaflex injections for your Dupuytren’s contracture in both hands, with yet one more to go. This makes it sound as if your doctor is still treating your problem; you believe your procedure has gone well, even though you it is still ongoing. It would be really interesting to hear back from you a year or two from now, so that our readers and I could learn how your hand recovery advances and to monitor your experience with recurrence.

    I appreciate your recommendation that the Xiaflex procedure should be done by a hand specialist. Some of the worst stories seem to come from people who had their Dupuytren’s contracture injections done by someone with limited training and experience. In my opinion, Xiaflex injections can be tricky to do accurately and well; it is important that you have someone with a lot of experience injecting those enzymes into your hand. I agree with you, Linda, don’t get just anyone to do it.

    Again, it is wonderful to hear you are happy with what has happened with your Dupuytren’s contracture. Good luck and I sincerely hope your progress continues. TRH

  16. Margaret cooper says:

    I had a Xiaflex injection for Dupuytren’s contracture 7 weeks ago and have had intense pain in my shoulder, arm pit and elbow ever since. I have constant tingling from my elbow into my hand. I am scheduled for an EMG/NCS test next Thursday. I hope that this test will give the doctors some answers as to what is going on and what to do to relieve my pain. I hope that there is something that can be done to relieve my pain and that this is not permanent.

  17. Dr.Herazy says:

    Greetings Margaret,

    Your problems might now be larger than just your Dupuytren’s contracture. I am concerned about what is going with your entire arm as a result of your recent Xiaflex injections. Of course, you have given me very little clinical information to work with, I am not your treating doctor and I have never examined you, and so to answer you I must speculate and correlate information I have received from other people who had very similar complaints.

    You are unfortunately not the first person who after receiving Xiaflex injections for Dupuytren’s contracture has noted unusual complaints of migrating elbow, shoulder and arm pit pain and tingling. What I am going to mention is based on the experience of others and might easily have nothing to do with what is going on with you. I could easily be wrong, and I hope I am. The reason that I mention these other people’s drastic experience is to help you by offering this information that you should pass on to your treating doctor; this might help your doctor more quickly and efficiently help you. I mention this at the risk of frightening you, because if this does apply to you it is important that you act quickly.

    These people who had migrating pain and tingling from the fingers to the arm pit were suffering from poorly performed Xiaflex injections that resulted in the collagenase (Xiaflex) actually traveling up the chain of lymph nodes, eventually collecting in the arm pit. With this collagenase in the lymph nodes of the arm pit it dissolved most of the tissues of the region and even destroyed the shoulder joints in some cases. At least a few of these people eventually had to have a new shoulder joint implant, among other corrective surgeries. You need to immediately contact your doctor with this information and take whatever steps are necessary and appropriate in your case.

    I suggest you get a second opinion from a hand specialist who has a lot of experience treating Dupuytren’s contracture with Xiaflex, not just the doctor who did your Xiaflex injections. Also, I suggest that you consult with the best orthopedic surgeon you can find if any bone or joint damage is suspected. It would be wise that you write notes about all your conversations with the doctor who gave you the Xiaflex injections for your Dupuytren’s contracture, as well as what happened and how you felt. Write down everything you can remember about what has happened since your Dupuytren’s contracture injections. Everything. Tell your doctor everything, and do not hold back information even though things might not look like they are going well at this time.

    Good luck to you. TRH

  18. Bryan G says:

    I had Xiaflex injections for Dupuytren’s contracture 4 weeks ago in my small finger and middle finger. The palm of my hand is still very tender and hard to grip even my steering wheel in my car. When my Doctor popped the cord in my middle finger, the cord now protrudes outward in the middle of my hand. Does this sound normal?

    Before the injections the palm of my hand was smooth and I had a firm grip, but now with the cord raised in my palm I’m in a worse condition than before. When I showed this to the Doctor who treated my Dupuytren’s contracture, he said that we all expect more from medicine.


  19. Dr.Herazy says:

    Greetings Bryan G,

    Over time we hear more about bad reactions after Xiaflex injections for Dupuytren’s contracture. Your description sounds like one of the ends of the broken cord has curled up within the palm, causing pain and reduced ability to use that hand.

    You are not the first person to say you and your Dupuytren’s contracture hand were better before your Xiaflex procedure than after it.

    Did your surgeon explain that a protrusion of the freed end of Dupuytren’s contracture cord was possible? Were you told that a less than perfect outcome was possible? Did the hand surgeon explain anything about recurrence of the original Dupuytren’s contracture problem that you would eventually have to deal with?

    Your description of how your surgeon responded to your new hand complaints suggests that he/she is satisfied with the outcome of your surgery, but feels that the real problem is that you are expecting too much from the Xiaflex surgery. While I think this is preposterous, it is a common defensive attitude that many surgeons take when a surgical outcome is questioned. If indeed the surgeon did not prepare you for a less than perfect outcome to your Xiaflex procedure, and perhaps even told you that something like “you will be as good as new after surgery,” then based on your description I believe you do have a very legitimate complaint. With Xiaflex injections I see that many doctors do not fully explaining the limitations of this procedure or the potential risks involved when used for Dupuytren’s contracture, resulting in many patients exposing themselves to a risky procedure without adequate information for informed consent.

    I suggest that you get a second opinion about the current state of your Dupuytren’s contracture and what can be done to help you, using another surgeon located as far away from the first surgeon as possible. Unbiased evaluations and independent second opinions can suffer if doctors know each other.

    Please keep this readership informed about what happens next. People with Dupuytren’s contracture need to know about the extreme and disappointing responses that can arise because of Xiaflex injections. Thanks for stepping forward. TRH

  20. Michael Andrews says:

    I wish I had never had any Dupuytren’s contracture SURGERY done…..I feel that it ripped my finger apart …inside and out……6 months later. It was very painful……Now my finger won’t close all the way… other fingers are not the same.

  21. Dr.Herazy says:

    Greetings Michael,

    Thank you for sharing your experience with hand surgery for Dupuytren’s contracture. Although you did not say so, it sounds like you had a failed Xiaflex injection. This kind of reaction does not happen in all cases, yet it is common enough that people should know that the Xiaflex procedure is not as simple and fail-proof as surgeons tell people. There are a lot of really bad Xiaflex reactions out there and apparently they are more common than patients are being told.

    I am concerned about your last comment: “my other fingers are not the same.” Perhaps the Xiaflex collagenase enzyme that was injected into your hand leaked out or too much was used, allowing it to spread out and dissolve normal tissue around your healthy fingers that are not affected by Dupuytren’s contracture. Please get a second opinion about these other fingers, as well as the current state of your Dupuytren’s contracture and what can be done to help you. Locate another surgeon as far away from the first surgeon as possible. Unbiased evaluations and independent second opinions can suffer if doctors know each other.

    The outcome of any surgery is in great part determined by the skill and experience of the surgeon; more so perhaps when it comes to Dupuytren’s contracture. Patients should take far more time and effort to determine just who it is who will operate on them. And yes, as far as I am concerned a Xiaflex injection for Dupuytren’s contracture is indeed surgery. Don’t let any doctor play down the risk and complexity of the procedure to make you think it is an easy way to correct your Dupuytren’s contracture.

    Please let us know how you and your Dupuytren’s contracture treatment goes in the future. Good luck. TRH

  22. Thomas J says:

    After reading these stories it appears that I am one of the more fortunate souls that have had the Xiaflex injections for Dupuytren’s contracture. Treated in early December of 2017, three different areas of the right ring finger area and palm area. Limited swelling and black and blue discoloration limited to the palm and knuckles. Painful the first several days but gradually subsided. Most painful was the three injections and then the additional two injections two days later to freeze the hand prior to manipulation.

    From reading the doctor’s comments it seems like prospective candidates for this Dupuytren’s contracture procedure best be advised to find the best hand surgeon available and one that has a sound history of this procedure. Fortunately I think my doctor is a good one, and does have a lot of experience with this drug.

    What is interesting from reading some comments here is I am now finally able to figure out why I had severe back pain the day after my procedure. I have a history of back problems, having had a laminectomy many years ago. Since then my discs have deteriorated further and to make a long story short, a double or triple-level fusion is the only thing that can supposedly give me total relief. I have good days and bad days and never know what to expect every day.

    Anyways the evening after the injections i started having back pain and took a motrin before bed. This usually helps when I only have moderate pain. This time it didn’t work. I went to bed with back pain and at 3:00 in the morning woke up with severe pain. Made it to the floor with an ice pack and lied there for half an hour. Fortunately I also had some heavy-duty medication available that my shoulder doctor prescribed for me but never took as didn’t want to take narcotics if not truly necessary. Made it back to bed and my back was somehow good enough for me to go to my hand appointment the next day for the manipulation.

    It’s rare I have such severe back pain but from reading comments from the doctor, it’s highly probable the Xiaflex infiltrated my disc area which is already compromised with a degenerative condition including much arthritis I’m sure.

    I have no idea what I’ll do in the future should this condition reappear. I lived with Dupuytren’s contracture for at least a dozen years and it didn’t really prevent me from any normal activities. But the degree of curvature got to be greater than 30 degrees which is what my doctor suggested could be the point at which some action should be taken.

    Hope this info helps your institute and your readers. Although I had excellent results (so far) with minimal side-effects to my hand, I’m quite confident this drug caused the severe back pain one day later.

  23. Dr.Herazy says:

    Greetings Thomas J,

    Thank you for your detailed and informed report.

    You are generously reporting a “favorable” response to your Dupuytren’s contracture procedure six weeks or so after your Xiaflex collagenase injections. I am happy you feel that way. We do not hear much about that kind of thing on this website. However, when you mention how Xiaflex injections exacerbated or worsened your chronic back problem you contradict your assessment. How or why Xiaflex can infiltrate and adversely influence tissue three feet away from the hand (spine) is something that must be given serious investigation; that is a big scary deal.

    As serious as the consequences might be in your case when spinal discs are affected by Xiaflex migrating out of the target area, what might happen if Xiaflex injected into the palm is picked up by another lymphatic channel and migrates to the brain, heart, lungs or liver? The results could be catastrophic. Don’t say it can’t or shouldn’t happen; Xiaflex is already showing evidence of migrating from its target tissue (hand) and apparently destroying shoulder joints and spinal discs – why not the heart or other areas? Given that lymphatic vessels follow a standard pathway in most cases, anatomical variations do occur. Perhaps in the next person with Dupuytren’s contracture their lymphatic ducts might make a strange bypass and deposit the Xiaflex to lungs or elsewhere. It is certainly not something that would happen often, but is it worth the chance that you might be the unlucky one?

    Yes, your Dupuytren’s contracture will recur; it is just a matter of time. For some the hand contracture can start several or many years later, and for others it begins in less than a year. There is no easy way out of Dupuytren’s contracture using drugs or surgery; that is not the nature of this insidious fibrous infiltration. When that happens you will certainly be better informed than the average person.

    Thank you so much for information about how your Xiaflex injection affected your back problem, and how this correlates with similar experiences of others. Good luck with your Dupuytren’s contracture and I certainly hope your recovery continues to be uneventful. TRH

  24. Danielle Huffman says:

    My mother had her Dupuytren’s contracture treated with a xiaflex injection in March (three months ago), and now has no use of her right hand at all. It’s still swollen and basically just in the way. She can’t brush her hair, wash herself with that hand, or even brush her teeth without difficulty. I was present when the doctor injected and released her cords. The movements were very rushed and done quickly and I’m wondering if he possibly released the cords too fast or injected it incorrectly. She did return to get help about the loss of her function and they did xray and sent her home and told her there was nothing more they could do for her and said that they have never seen this before and don’t know what’s wrong. I requested her records myself and read the xray report. It said “Evidence of fracture or misalignment in hand.” Her hand was not fractured or injured before they did this to her. Also, she was never given a consent form to read over and sign before the procedure. Overall, we are very upset at how this “prestigious” hospital has handled this issue. We have contacted multiple lawyers and they have turned us down. She’s been to two other hand specialists with no help. I’m at a loss as to what to do now. Has she lost function in her hand forever?

  25. Dr.Herazy says:

    Greetings Danielle,

    So sorry to learn of your mother’s problematic response to Xiaflex for Dupuytren’s contracture. The force needed to break the Dupuytren’s cord is sometimes great, especially when it is not properly weakened by the enzymes. I have heard hair-raising stories of what is done by doctors with a poor technique or low skills when confronted by a non-responsive cord; it can be brutal.

    Your story confuses me. If her hand x-ray report clearly and directly states there is evidence of fracture and/or misalignment of one or more bones, that would explain her loss of hand function. But it would not explain the hospital’s lack of interest or inability to help her; why two hand specialists could not assist her; why several attorneys have turned down her case. Perhaps there are other aspects or facts of her case you did not include that are important to evaluate her Dupuytren’s contracture treatment with Xiaflex.

    I suggest you go as far away as possible from the hospital to seek additional attention for her; a hundred miles or more. This will increase the chance she will receive an unbiased evaluation of her current status. Doctors protect their friends in cases of medical malpractice. If you go a considerable distance away that tendency is reduced. If her basic problem is now simply a fracture or dislocation in the hand you should have no trouble getting the help she needs.

    Good luck to both of you. TRH

  26. Robert Bloemendaal says:

    Hello, I had NA done for Dupuytren’s contracture 3 times in CA with great success… but it came back even worse in 3 years. Moved to MT and had ins that covered a Xiaflex injection for my little finger which was nearly at 45 degrees. Should have waited to go back to the NA guy in CA. Seemed like the injection did not break down the cord as planned, and the manipulation was brutal, I thought he broke my finger. The wound was huge and required a skin graft procedure (with some kind of new material) to avoid infection… he said. Anyway now my finger is worse than before, won’t bend all the way, swollen sore joint, one year out… and it is already getting bent again. Mad at myself for not sticking with NA for the Dupuytren’s contracture, now my finger is permanently ruined… no more mandolin or guitar for me… 63 years old.

  27. Dr.Herazy says:

    Greetings Robert,

    What a sobering story. But, I am not sure I understand what you mean about the outcome of your past NA hand surgeries for Dupuytren’s contracture.

    You say you had three NA procedures “with great success,” but “it all came back even worse.” Is that really great success? Three fast recurrences of Dupuytren’s contracture and yet the surgeon went back in each time, even though you showed you were developing DC as fast as he/she could tear it up with a needle? How is that great success? It was only because your NAs were a failure that you considered more hand surgery. Three hand surgeries in three years is not great success by my standards.

    (For readers who do not know what NA hand surgery is, it is actually called a needle aponeurotomy. This means that a surgeon inserts a needle under the skin near a Dupuytren’s contracture cord and then slashes away at it without being able to actually see what is being done; it is done by “feel.” The purpose of a needle aponeurotomy is to cut and shred the fibrous cord of DC. The problem is that the two ends of the partially or completed cut cord remain under the skin, and they grow back — almost always worse than before, as this writer has mentioned.)

    After three NAs in three years your hand was again bad enough you decided to have a Xiaflex injection surgery. You feel this caused far worse results, and you blame the Xiaflex procedure for all your current hand problems. Perhaps you should reevaluate your thinking about that. If you did not first have those three NAs with all the tearing and slashing, and all the repeated recurrence or rebuilding of the cords after each one, perhaps the outcome of your Xiaflex injection surgery would have been different. Now in my opinion Xiaflex surgery is a risky procedure with a fast recurrence rate of its own, and often causes the problems you mention (great pain while breaking the cord, skin eaten up and eroded by stray Xiaflex that destroys the palm tissue, wounds that do not heal except with plastic surgery, nerve, ligament and tendon destruction, pain and limited use of the hand, etc.). In your case I suspect the outcome of the Xiaflex injection surgery was worse because of the three NAs that preceded it. Your two doctors should have explained all this to you before each procedure, and told you about the diminishing success that can occur after each hand surgery. The more internal tissue you change, cut, remove and patch up, you increase the opportunity for problems.

    Thank you for writing this post and documenting your experience.

    I am deeply sorry for the way your four hand surgeries have left you. I wish it was better for you. I hope this helps other people understand that any surgery (NA, Xiaflex injection, fasciotomy, fasciectomy, Z-plasty, etc.) for Dupuytren’s contracture can have bad outcomes due to the nature of the problem. Be aware. TRH

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