callie:

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Linda, this could be the best information from what could be considered a third party direction.

http://www.aetna.com/cpb/medical/data/800_899/0800.html

lori:

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Callie,

That is great and very informative. I wish I could find that under my BCBS benefits.

Lori

I gathered the RT publications from medical journals, most of which are referred to on this site and presented them to my GP to get a referral to an radiology clinic where I knew there was a radiologist who was willing to use RT to treat benign conditions. If DD is a clear diagnosis and active, my suggestion is to do as much research as possible and be firm, polite and assertive and do not assume that your GP will have any knowledge of DD treatments other than surgery. I was prepared to have to argue my case but the GP was very receptive, maybe I was lucky.

And with our fingers and surgeons, the nail has to be bent about 35-45 degrees before they want to take a whack at it. I've never had this fully explained as to why that is. My guess is that up to that point the hand is still highly useful and they are well aware that a hammer is a blunt instrument.

You've got to love this very bad advice from WebMd:

"Surgery may be recommended for severe cases of Dupuytren's disease in which the tissue beneath the skin in the palm thickens to the point that your hand movement is limited. Consider the following when making your treatment decision:

Before considering surgery, you might try nonsurgical treatment including physical or occupational therapy and home stretching exercises."

Hello........WebMd. NA? Collegenase? RT? Anyone? Anyone?

Apparently not.

This is from WebMD. All the procedures are mentioned on this site and many other WebMD sites.

http://www.webmd.com/a-to-z-guides/dupuy...eatment-options

"Enzyme Injections

If your finger is already bent, your doctor may recommend Xiaflex, a mixture of enzymes that is injected into the affected area to break up the tough tissue. The drug loosens the tissue. If the contracture is still present on the following day, your doctor will stretch your finger and try to straighten it. The injections are given in the doctor’s office and may be used as an alternative to surgery. Your doctor will also recommend certain stretching exercises after the injections.

Most people need one or two injections in the affected joint, but some people may need up to three injections to straighten or nearly straighten the finger. The most common side effects are swelling in the affected area or bleeding, bruising, and pain at the injection site. Rarely, more serious side effects, such as damage to a tendon, nerve injury, or allergic reaction may occur."

Needle Aponeurotomy

An alternative to open surgery is an office procedure called needle aponeurotomy. The surgeon uses a hypodermic needle to divide and cut the diseased tissue in the palm and fingers.

This procedure is less invasive and leads to a quicker recovery than open surgery. Many do not need rehabilitation with physical therapy following the procedure. A presurgical evaluation can determine whether you are a candidate for this procedure.

Surgery for Dupuytren's Contracture

What if it becomes difficult for you to grasp objects or perform other daily activities? Your health care provider may recommend surgery if your disease progresses. The goal of surgery is to restore motion in your fingers.

Open Surgery

The surgeon makes an incision and either divides (fasciotomy) or removes (fasciectomy) part or all of the thickened bands of tissue.

A variety of techniques are used to close the wound. Sometimes a skin graft is needed for the incision to completely heal. To do this, the surgeon takes healthy skin from another area of the body and attaches it to the area in the hand that needs to be closed.

Edited 04/03/13 23:22