RonSB,

The answer is quite straight forward. NA Vs Open Surgery is *not* an Eithor/Or proposition. It's Both/And. As in many forms of medical treatment you always start with the least expensive, least invasive and least dangerous. If the entry level treatment is not sufficient, you move up the ladder until something works. You don't start at the top.

NA is an entry level procedure, not the final option. So, you can try NA first and if it turns out that your eager surgeon is right and that NA is not sufficient, you move up to full surgery.

Ask the surgeon this. Has he ever personally *seen* the results of NA on a patient for which he was advising OS? I doubt it. If not, he's talking from theory not actual real life experience. How much actual experience with NA does he really have to advise against it? I'll bet none. Meanwhile Eaton is an expert in *both* OS and NA.

No one can guarantee outcomes. But statistically I can say this. NA is safer than OS. But...it has a higher rate of recurrence, which means statistically you would need to do it again sooner than if you had the surgery.

You pick your poison around here. But why not start with NA? Personally I've had both OS and NA. I'll avoid the OS as long as possible. If your disease is slow moving and you are older, NA may be all you'll even need, though it may need to be repeated.

NA is like getting a car tune-up. OS is like rebuilding you engine.

Hello there...I also went to a hand surgeon in 03.....He recommended the old regular hand surgery.....I found this forum on my own and went to Dr. Eaton...I have never regretted going to Dr. Eaton..My finger has gradually turnerd back downwards....about 90.....The N.A. IS NOT A CURE, BUT IT SURE BEATS THE SURGERY BY A LONG SHOT....

I am a 56 yr old male who began having symptoms of DC in my rt ring finger about 20 yrs ago, soon after carpel tunnel surgery on the same hand. By March of this yr, there was a 60 degree contracture so I decided to schedule surgery with Dr. Greenberg at the Indiana Hand Center in Indpls. I happened across the NA procedure while surfing and read every relevant article I could find. I cancelled my surgery appointment and left a message with the surgeon's nurse to have him call me to discuss, since NA was never suggested as an option. During our conversation, she speculated that Dr. Greenberg probably didn't consider me a candidate for the procedure. Suppose I'll never know for certain what he was thinking, since he never returned my call.
Anyway, I contacted Dr. John Mahoney at Midwest Ortho in Peoria IL, a hand surgeon who performs NA. I sent him photos and he responded immediately. I scheduled a consultation and it was understood that if appropriate, the procedure could be performed on the same visit. I made the 3-hr drive to Peoria 7 days ago and couldn't be happier. There was virtually a full release of the contracture, and in less than an hour I was driving home. The worst part was a 1/4" skin tear from where it had been puckered over a number of years. The tear seeped for a couple of days and required a gauze pad. However, I resumed near normal activities immediately, and the bandage gave way to a band-aid within 3 days. After 5 days, the band-aid came off. On this, the 7th day, the tear wound is about half the size and, at this rate, should be fully healed in another week. Compared to open surgery, this is truly a NO BRAINER. And I didn't even mention the cost savings--THOUSANDS!!! If you live in the midwest and are contemplating NA, I would highly recommend contacting Dr. Mahoney.

Jackstraw

Unfortunately your story is a typical example (and warning) for new readers of this Forum that their otherwise highly regarded CHS only *think* they know what they're talking about when it comes to NA. Many of us have had to learn the hard way for their ignorance/bias.

At the same time it must be said that NA has it's limits and Open Surgery may be necessary for some in the end. However, always check with a CHS who does *both* to evaluate your case. They are the only ones who qualified to know the strength and weakness of both procedures. You don't consult a fighter pilot regarding hang gliding.....unless he has done it himself.

You are in good hands with Dr. Keith. He has pioneered the use of doing NA through existing scar tissue and may still be the only surgeon doing this. If he can't fix it, it can't be done. At least you will not have made the mistake of taking bad medical advice twice.

Edited at 30.10.07 01:17

My hand surgeon, who performed several very skilled operations on both my hands in the 1980's, has recently added NA to his repertoire of techniques. He mpresses me as not being the kind of person to adopt any technique without thorough investigation and careful consideration -- I would describe him as conservative and cautious. He has been a hand surgeon for decades now and has had an excellent reputation, which is the reason I went to him in the first place.

The fact that he has started using this procedure suggests to me that it will soon be a mainstream ttreatment for dupuytren's in North America.