Dr. James Verheyden, Hand and Upper Extremity Orthopedic Surgeon, explains how to recover from Xiaflex injections for Dupuytren's Contracture.

For pain, take Tylenol 650 mg 3-4 hours after the injection and manipulation days and then, if you can take NSAIDS, alternate 650 mg of Tylenol with Ibuprofen or another NSAID every 3-4 hours for a couple days.

No ice for 6 hours after the collagenase injection as the enzyme is temperature-dependent. The enzyme stops working after 6 hours. After 6 hours, begin using ice, strict elevation, and finger range of motion exercises for swelling and pain.

Expect swelling, bruising, and tenderness in the hand. Skin splits are common after the manipulation procedure. It is hard to go from a severely contracted finger to a completely straight finger, and not have your skin split open. The wounds sometimes look very large and shocking but these wounds heal. Soak the hand in warm water with Epsom salts.

Many times skin splits are beneficial as they make it easier and quicker to get the fluid and swelling out of your fingers and the wound heals with new, non-diseased skin.

Stretches
#1: Massage the palm and fingers to desensitize the nerves and help with swelling/edema. You can be quite firm with massaging
#2: Take your opposite hand and squeeze your fingers all the way into a ball.
#3: Take your opposite index finger and bend your wrist, bend your finger at the MCP joint. Make what I call is the “letter C” and then reach under your finger and fully extend at the PIP joint.

This will push out all the fluid, swelling, and blood in your finger and hand, greatly accelerating your rehab. Do these stretches for 1 minute total, every hour that you are awake for at least the first 2 weeks.

Wear the splint just at night, every night for the first 2 weeks. Do not wear the splint during the day. It is more important to stretch and keep manipulating your fingers.

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