Hi, I have had Dupuytren's in my right hand for quite a few years now and my pinky is contracted severely. I had the NA procedure done a year ago and while the procedure straighten my pinky considerably it only lasted a few months. I talked with my surgeon (he is one of the best) he said that since it returned so aggressively, I was not a candidate for another NA procedure and said I should look into hand surgery... after reading up on the open hand surgery I am concerned about having it done... Is it worth the risk of the disease jumping to other areas? Am I hurting myself in the long run if I don't do anything else..... am I increasing the risk of losing my finger? Thanks in advance for your feedback... Anne

I'm like Callie, except that I think I had some more post op pain than she experienced. I was eating Vicodins for about two weeks. I was in a lot of pain. But, like Callie, 14 years after surgery on my left hand ring finger and middle finger, and to release the tendon sheaths, I am better than I was before the surgery. I have some cords and nodules that developed right after the surgery, but they never contracted. My hand is great. But, as Callie said, we're all different. So, I'm not saying that if you have the surgery everything is going to be hunky dory, like it is for me. But, I really don't think that doing nothing is better than surgery. If your doc is recommending surgery, give it some careful consideration.

I just had Xiaflex injections into my palm and ring finger of my right hand about two months ago. My hand is not as good as my left hand, and the doc said it's really not going to get any better than it is right now. That's disappointing to me, but at 15 degrees of contracture, I can live with it. If it begins to contract more, I'm going for another dose of Xiaflex. I opted not to do the surgery because I could pick other procedures. When I had the left hand palmar fasciectomy 14 years ago, there were no other options. I opted for the Xiaflex because I've read that it doesn't have the recurrence rate that NA has, though some people will debate that. For me, the jury is still out. ~Diane

Randy_H:

---

And sadly no one knows of a way to slow agressive disease it down.

I just got back from a consultation with a hand surgeon who recommended surgery plus a skin graft to prevent recurrence. About 18 months ago I had N/A done on my little finger of my right hand as my PIP was at 90'. It had contracted to 90' very quickly. The N/A got the finger almost straight but within 3 months it was contracting again. A month or two ago I tried N/A again on the same finger, but the Dr. was unable to straighten the finger, telling me that the fibrous tissue was too deep to get to without damaging nerves etc. He recommended surgery. I had traveled to Arizona for the N/A as no one did it here in Colorado, but I will have the surgery done in CO.

The surgeon I saw today is not a fan of N/A but I don't have that option on this finger any more anyway. I will go ahead with the surgery, and probably the skin graft too as it seems to help prevent recurrence. He wanted to remove nodules in the palm as well, but I am opting just to remove the tissue in the finger itself as the MP joint is not involved. I will have my other little finger done next spring. It is at about 35' right now. I will continue to travel to get N/A as my other fingers contract because I believe in keeping it simple. Surgery should be a last resort, which it is on my pinkies.

"I think any procedure can precipitate the progression and activate the disease."

That's why most of the time surgeons remove all the diseased tissue in a "Limited fasciectomy" procedure, which is what is referred to as Open Surgery (OS)

https://en.wikipedia.org/wiki/Dupuytren's_contracture#Limited_fasciectomy

However, Wikipedia is reporting twice the recurrence rate with NA Vs OS. That means that normal OS without skin graft will only be 50% better than NA. Considering all the issues with OS (read the above Wiki article) that 50% doesn't seem worth it unless you add a graft. Even then there is no guarantee. I don't know what the recurrence rate is with a graft. Does anyone here know the stats?