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08/29/2015 11:37
Broderbund 
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08/29/2015 11:37
Broderbund
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Daily Contracture Changes
I have a 20 degree contracture in my pinky pip joint. Seen a very experienced NA Doctor who has advised me to wait three months or so to see how quickly the contracture progresses.
She also advised me to begin wearing a splint at night. I've noticed when I wake up in the morning my finger is considerably straighter (can almost lay my hand flat on a surface) but as the day progresses the bend again becomes more significant.
Anybody know why this occurs.... Should I consider wearing a splint during the day as well???
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08/29/2015 16:31
newman 
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08/29/2015 16:31
newman
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Re: Daily Contracture Changes
Hi I have just spent a couple of hours this week with Dr Meinel in Wuezburg in Germany. He was the first Dr to use NA in Germany having gone to Paris and completed the training . One of the topics we discussed is when to carry out NA. within the hand and also within the Pip joint. 20 degrees is optimal . Don't wait longer especially in dealing with the pip joint as some deformation within the joint capsule may inhibit the straightening. He has pioneered the use of the night splint for decades. Definitely he advised me not to wear any splint in the daytime. He has had good results to straighten the hand ,in some patients not having to have any intervention at all , and only using a night splint. I would suggest having a splint made . The hand is held in the passive position ,which prevents making a fist whilst sleeping. The splint does not place any pressure on the finger to force any straightening of the affected finger.
I was advised NOT to wear an active Spring type splint. Finally if you choose to wait, use the simple Table Top test to take some measurements and monitor the progress or regress if you choose to wear the splint in the first instant.
Edited 08/30/15 12:23
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08/29/2015 20:38
Cherise 
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08/29/2015 20:38
Cherise
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Re: Daily Contracture Changes
Broderbund:
I have a 20 degree contracture in my pinky pip joint. Seen a very experienced NA Doctor who has advised me to wait three months or so to see how quickly the contracture progresses.
She also advised me to begin wearing a splint at night. I've noticed when I wake up in the morning my finger is considerably straighter (can almost lay my hand flat on a surface) but as the day progresses the bend again becomes more significant.
Anybody know why this occurs.... Should I consider wearing a splint during the day as well???
That's why I wear a spring splint during the day . It's only been 6 months since my finger was straightened by Xiaflex injections. My doctor told me I must wear a splint at night forever fo all three fingers, and spring splint when necessary during the day. Like writing , slicing, etc. depending on the use on the hand.
Everyone's DD is different. You may want to schedule an appt with your doc for you particular case and stage of DD.
Kind Regards
Cherise
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08/30/2015 09:43
newman
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08/30/2015 09:43
newman
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Re: Daily Contracture Changes
Hi Cherise I underwent repeat NA on both index fingers back in Australia in March of this year. Xiaflex is approved in Australia but the cost of $1700 a vial is not subsidised , either in Germany. The cost is all out off pocket expense. I was given a DeRoyal spring splint to wear in the day .The splint can be adjusted to increase or decrease the tension on the pip joint . A couple of weeks back ,I visited Professor Staub ,who is also a neurosurgeon close to Heildelberg Germany . He examined the splint made for me back in Australia, as it is not easy to purchase ready made splints for index fingers. I also showed him the DeRoyal spring splint i was given and I was advised not to use it . (counterproductive in the treatment of Dupuytrens) . The hand should only have a passive splint which does not exert any pressure on the fingers.
Edited 08/30/15 13:21
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08/30/2015 10:54
wach  Administrator
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08/30/2015 10:54
wach Administrator
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Re: Daily Contracture Changes
What you are describing is perfectly normal. Because of splinting the hand is straighter in the morning and it starts bending again in course of the day. Splinting makes your hand stiffer (you will notice that in the morning) therefore recovering flexibility during the day is important. With permanent splinting your joints will probably become stiff.
Wolfgang
Broderbund:
I have a 20 degree contracture in my pinky pip joint. Seen a very experienced NA Doctor who has advised me to wait three months or so to see how quickly the contracture progresses.
She also advised me to begin wearing a splint at night. I've noticed when I wake up in the morning my finger is considerably straighter (can almost lay my hand flat on a surface) but as the day progresses the bend again becomes more significant.
Anybody know why this occurs.... Should I consider wearing a splint during the day as well???
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