| should I go under the knife? |
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01/23/2011 19:21
papa_65 
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01/23/2011 19:21
papa_65
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should I go under the knife?
Hi, I just found this site thanks to my wife. I have Dupuytrens in both hands, my right hand is the worst. It was contracted to the point where it was almost held against my palm. My doctor used NA on me and got it to about fifty to sixty percent closed, and told me that the needles wont do anymore for me. Im suppossed to have surgery in Febuary but Im having second thoughts. I dont know how long the results of the surgery will last or should I just have the effected finger amputated and be done with it once and for all. I would appreciate any imput from other people that may have any sujestions, thanks.
Edited 01/23/11 21:22
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01/23/2011 20:47
David26not registered
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01/23/2011 20:47
David26not registered
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Re: should I go under the knife?
a couple questions for you:
- where are you located?
- how long have you had DD, how many fingers affected? I assume you are referring to your little finger on the R. hand.
- who is your hand surgeon if you don't mind saying?
- how long ago was the NA procedure?
- what is your surgeon saying about what he expects this surgery to achieve?
- is a skin graft planned?
- do you have any relatives with DD? could be an indication of aggressive DD which can be highly recurrent
I've read that some extreme sufferers feel better off with amputation but I think most would consider it as a last resort. It sounds bad but we are not in your shoes. I would try everything else first myself. I'm not sure that radiation therapy or Xiaflex would help for your situation. Your surgeon should know about Xiaflex. Perhaps your situation is too far advanced for those methods?
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01/23/2011 21:10
callie 
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01/23/2011 21:10
callie
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Re: should I go under the knife?
I had 90 degree contraction on my little finger. Nine years ago I had a limited fasciectomy. I have no sign of Dupuytren's in that hand at this time. It is as good as it was prior to Dupuytren's. Naturally, as with any surgery, different people have different results. It is very important to find a hand surgeon who has had extensive experience with Dupuytren's.
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01/23/2011 21:57
LubaM.
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01/23/2011 21:57
LubaM.
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Re: should I go under the knife?
I agree with David26 myself....but he's right, we are not in your shoes....for me, I would try everything else first.
After the questions asked are answered, we will be able to offer suggestions. In the end, its your decision.
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01/31/2011 23:36
bstenman
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01/31/2011 23:36
bstenman
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Re: should I go under the knife?
Very high rate of complications with a fasciectomy that is in part due to chance for infection but mostly seems to be a side effect of loss of blood flow for 90+ minutes with the tourniquet. Recovery time with a fasciectomy can be anywhere from 3-12 months and no way to predict your outcome. Recurrence statistics show same odds of problems again with fasciectomy, Xiaflex, or NA, at this point in time. Too little information on too few patients and too little time has passed for an accurate assessment of Xiaflex.
A fasciectomy is the very last procedure I would contemplate. If NA is not an option I would consider Xiaflex.
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02/01/2011 02:57
cindy850
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02/01/2011 02:57
cindy850
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Re: should I go under the knife?
I did rt and its been 1 year now. Never never never would i ever think about surgery.
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02/01/2011 02:58
callie
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02/01/2011 02:58
callie
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Re: should I go under the knife?
bstenman,
You said, "no way to predict your outcome (with a fasciectomy)". Are you suggesting that it is possible to predict the outcome with NA or Xiaflex?
You said, "Recurrence statistics show same odds of problems again with fasciectomy, Xiaflex, or NA, at this point in time." That is not true, is it? I have never seen that conclusion in any study. Also, the degree of difficulty (greater contraction) is associated with fasciectomies when compared to NA.
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02/01/2011 03:02
callie
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02/01/2011 03:02
callie
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Re: should I go under the knife?
So Cindy, are you suggesting that the original poster have his finger amputated rather than have a fasciectomy? That was his question. His doctor who did NA suggested surgery.
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02/01/2011 04:34
cindy850
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02/01/2011 04:34
cindy850
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Re: should I go under the knife?
If i was in the same spot he is in -yes i would amputate my pinky finger and be done with it because at least you don't have to worry about it coming back and all the time spent in physical therapy and lets include scare tissue and grafting. A non ending story. I'm not upset with anyone but i would amputate my finger before i mutilate my hand. Take care
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02/01/2011 05:12
callie
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02/01/2011 05:12
callie
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Re: should I go under the knife?
Cindy850,
I'm glad that is only your opinion. It would be terrible if that was everyone's opinion about fasciectomies. It sounds as though you aren't very well informed about fasciectomies. Most people are satisfied with the results of a fasciectomy according to the studies I have seen. I was very satisfied.
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