| Needle Aponeurotomy and
Xiaflex collagenase treatment accomplish the same goal: cut the cord
without making
big cuts in the skin. With Needle Aponeurotomy, the cords are cut with
the tip of a needle at multiple locations; with Xiaflex, one section of
one cord is dissolved after being injected with the medicine. NA is
mechanical, Xiaflex chemical. An analogy of the difference is a clogged
drain: if NA is like using a plumber's snake (immediate result),
Xiaflex is
like using drain cleaner (put it in and the result follows a short time
later). Although both techniques have been described as "nonsurgical",
they are each minimally invasive fasciotomy procedures, one performed
with a miniature knife, one with a chemical knife. A comparison is
below. |
|
NA
|
Xiaflex |
Learning
curve
for
the
doctor
|
Longer
|
Shorter
|
Cost?
|
Less
|
More
|
Not
recommended
if...
(Contraindications)
|
- After some hand surgeries
- Open wound on hand
- Current hand infection
|
- After some hand surgeries
- Open wound on hand
- Current hand infection
- Lymph node surgery or lymphedema
- Pregnant, possibly pregnant, or breast feeding
- Prior allergic reaction to Xiaflex
|
What
can be accomplished
with one
treatment of one hand?
|
All
areas
of
multiple
cords,
multiple joints, multiple fingers |
One
section
of
one cord
|
How
many treatments are
needed per cord / joint?
|
One
|
Usually
one. Some
patients
need a second injection
|
Both
hands treated?
|
On
consecutive
days
|
On
consecutive
months
|
How
many appointments are
needed for a treatment?
|
One
office
visit
for Evaluation and
Treatment
|
Two
or
three
visits: Evaluation;
Injection; Manipulation.
|
How
long
does
the actual
treatment take?
|
10
-
20
minutes per finger |
Less
than
a
minute
|
How
is
the
hand bandaged
the night of treatment?
|
Remove
bandaids;
OK
to
wash or
shower
|
Change
bandages |
What
happens
the
day after
treatment?
|
Begin
hand
exercises:
Begin
night time splinting (some patients)
|
Return
to
office
for
finger
manipulation, possibly with anesthetic injection; Begin night time
splinting (some patients)
|
Common
issues
(experienced
by
at least one out of four patients) during the first
week
after treatment
|
- Mild
hand bruising
- Hand pain or tenderness
|
- Mild hand bruising
- Hand swelling
- Hand pain or tenderness
- Itching
- Breaks in the skin
|
Possible
complications
|
- Tendon Cut
- Nerve Injury
- Infection
|
- Tendon rupture
- Nerve Injury
- Infection
- Ligament Injury
- Allergic Reaction
|
Effectiveness
/
Recurrence
|
Probably
the
same
|