Jim,

I had a 90 degree little finger PIP contracture that had developed over 5-10 years before taking any action. Based on my research, I opted for NA in November, 2006, performed by Dr. Keith Denkler in Larkspur, CA (just outside San Francisco). Dr. Denkler is one of the leading US experts on DD and NA.

Results were excellent, the contracture having been reduced to 15-20 degrees (and holding thus far). In my opinion, this is a FAR better "first response" than going thru the recovery and other trials and tribulations associated with full open hand surgery.

Some say complication risks with open hand surgery are higher than with NA; some disagree. Some say recurrence is somewhat higher with NA, which seems logical given its nature vs the intrinsic nature of open hand surgery. Still, IMHO NA is a better first choice.

my husband underwent a transversal surgery five months ago. he is in bad shape. the little finger of his left hand is right back to a 45 degree bend and he has pain on a scale of 8 in the palm from the middle radiating outward to the little finger. diminished sensitivity from tingling to numb. finger is never a healthy color, ranges from blue to angry red. we were Never given any other option than surgery, and there is now a good chance of him losing the finger. be very careful to research this issue completely and seek a certified hand surgeon if you opt for that route.

the "surgeon" who performed this asserts that the return of the contraction must be due to his carrying his hand in a closed position, and denies any failure in the procedure. although we did go to a certified therapist, religiously followed the work prescribed ( and it IS work) and following directions to the nth degree the finger is so much worse than prior to the surgery it is ghastly. we are currently seeking second opinions and worried because the ring finger on the same hand is contracting now. the right hand is beginning to rope.

don't believe the surgeons who immediately want to cut, and RUN to another office. i wish we had done so. i did not do my due diligence on this issue. we had relocated to a completely new area, unable to rely on our network of physicians in Tampa and i dropped the ball by going with the recommendation of our primary physician. no one gave us any minimally invasive options.

Jim,
Dr. Denkler is a hand specialist and had done many surgeries for DD. After he found out about NA (needle aponeurotomy), he does that as a first option if it would work for the hand. He will tell you if it won't work and if surgery is the only option. He has successfully done NA on fairly severe contractions - 90 or more. He certainly will confer with you and discuss all options.

Take pictures of your hand and email them to Dr. Denkler. He usually will email you back within a day or two. I had NA done by him, then RT by Dr. T at Scripps in San Diego/La Jolla. For me, I decided that was the best option and still think it was best of all the options out there right now. RT stopped the progression for a while and progression is still significantly slowed.

I am going to be in NorCal next week and have an appointment for a consultation with Dr. Denkler. I want him to see what RT did and see the state of my hand now. I had/have a very aggressive case and my palm is cupping some now. Fingers still not contracting. I'll post after my consultation.

Good luck in your quest for the best options for you. Like Luba says, you are the one who will make the decision as to what is best for you. Keep researching and you'll figure out what to do and feel at least relatively sure that it was the right treatment for you. Then you just go for it and see how it works out. That's all any of us can do or have done. It truly is a weird disease. No 2 hands are alike, even your own 2 hands are different.

Flora

flojo:

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Jim,
Dr. Denkler is a hand specialist and had done many surgeries for DD. After he found out about NA (needle aponeurotomy), he does that as a first option if it would work for the hand. He will tell you if it won't work and if surgery is the only option. He has successfully done NA on fairly severe contractions - 90 or more. He certainly will confer with you and discuss all options.

Take pictures of your hand and email them to Dr. Denkler. He usually will email you back within a day or two. I had NA done by him, then RT by Dr. T at Scripps in San Diego/La Jolla. For me, I decided that was the best option and still think it was best of all the options out there right now. RT stopped the progression for a while and progression is still significantly slowed.

I am going to be in NorCal next week and have an appointment for a consultation with Dr. Denkler. I want him to see what RT did and see the state of my hand now. I had/have a very aggressive case and my palm is cupping some now. Fingers still not contracting. I'll post after my consultation.

Good luck in your quest for the best options for you. Like Luba says, you are the one who will make the decision as to what is best for you. Keep researching and you'll figure out what to do and feel at least relatively sure that it was the right treatment for you. Then you just go for it and see how it works out. That's all any of us can do or have done. It truly is a weird disease. No 2 hands are alike, even your own 2 hands are different.

Flora

Hi - I had a Needle Aponeurotomy from Charlie Eaton - there is a post from Ron about the procedure and it is spot on. It was the best medical experience I have ever had. No recurrence. My father had the traditional surgery - what a nightmare. A long and painful recovery, long and painful rehab, and poor results. His hands looked like hamburger. With the NA, it is a simple office visit and a few of those little circular bandaids that come off in a half hour. No rehab. I am an avid musician, and was scared of problems. But the NA is so minimally invasive - it is really nothing. Just a little novocain into the skin, go in a minimal distance with a hypodermic needle, slash the cord with the beveled tip of the needle. Cut the cord in five or six places and the finger is straight - and that is it. Talk about instant gratification.