I had RT 4 years ago on both hands and feet. My right small finger has gone from about 15 degrees to 60 degrees over the last year. I am considering either NA or surgery. I have seen a hand surgeon who strongly recommends surgery on basis that this would cut out the diseased material whereas NA would leave it there and would therefore have an increased chance of further procedures sooner. Would appreciate any views on this.
Always try the least invasive option first. If the cord is palpable, not twisted, an experienced surgeon might get a good result with NA or Xiaflex since the contracture is recent. Of course it might come back, and so too it might with surgery despite what you have been told. If it does you might be able to continue in 'maintenance' for a while with NA or Xiaflex. The recovery time with NA is often days, maybe weeks for Xiaflex, maybe months for surgery.
I am not an authority but .... all situations are unique... I had amazing results with NA back in 2009 about 95 degree pinkie..and I could not even see any cord ... Dr. Eaton ...did NA ..it is still near perfect to this day ..as is my middle finger that also was severly bent / contracted ... Find the most skilled /experienced doctor , DR. Diaz who took over Dr. Eatons Practice is very knowledgeable ...good luck
PS ..prior to my NA I also had a DR. that wanted to do open surgery ...glad I did not listen to him ...did research on this great site ....the rest is history
Hi I have had numerous surgeries on both hands , RT in 2007 and NA. Don't have surgery in the first instant. Firstly it is not possible to completely remove the Dupuytren tissue with surgery. I had NA in April 2015 with intervention through the pip joint and along the cord within the palm. After some months the body had consumed the cord within the palm. There is a medical term for this but I cannot remember what it is called. Have a night splint asap after the na. and wear it regularly. Don't wait too long .
Thanks for feedback. Have seen 2 surgeons and both confirm that the type of nodule on my little finger(large , thick and flat) makes NA almost impossible. That leaves only Xiaflex as alternative to surgery. Any views?
I had NA yesterday on the PIP Joint of my little finger. The nodule was fairly large and several doctors had told me NA would not be possible. And due to the nodule size and relatively small cord it had not been a good candidate for collagenase either.
But I think the NA worked out nicely. The joint did not become perfectly straight because it already had adapted to the contracture but it's much better now. The procedure was basically painless and a can use my hand after just one day.
Allan, I am no expert but I would have thought that the success of NA depends on the cord rather than the nodule. Are these two surgeons experienced in NA? I'd definitely get the opinion of someone who is.
Stef
[54 year-old male, DD diagnosis 2006, RH contracture and NA/PNF 2014, RT 2015, wearing night splint glove]
Allan, did you have any contraction at the time you had RT? If not, you would be among only about 15% of patients who require some surgical intervention within 5 years post RT. That would be disappointing I assume.
Thanks for responses. Both surgeons are competent in NA. The more experienced is totally convinced that it will not work in my case. Wolfgang thanks for pictures. My little finger is more bent and has a very thick pad under first joint. The finger was about 15 degrees bent at time of RT and interestingly was the only area unaffected by the rt treatment. (I had both hands and both feet done.) if na is out wonder about xiaflex or should I just go ahead with the surgery. The surgeon is very experienced and confident.
Good alternative. Xiaflex opened my fingers 2 years ago after I tried surgery and NA. Origionally I had no cords only small contraction in pinky. Surgery advanced the DD two fingers contracted closed and Xiaflex opened them and therapy helped movement and grip. See info on this forum for more info. I had the injections done approx 2 years ago. Have full use of my hands and wear a Fixxglove nightly to prevent contracture from reoccurring. There are videos available on the injections, its the least invasive treatment to begin. Good Luck
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