Stage 4 tubiana - too late to do anything new post surgery some 30 years ago??
I am writing on behalf of my mother who, at the age of 69years, has suffered from dupytrens since her mid 30’s. At the age of 40years both hands were operated upon in Alnwick, Northumberland (Dr J L Sher). Dupytrens are also present in both feet (toes). Hands and feet are aggressive with severe Stage 4 tubiana in both hands. Only one finger is ‘almost’ straight. Toes are curled and becoming painful to walk upon.
She believes that nothing can be done to help her as a result of her previous operation and also age, however I want to help her find out if there is indeed something that could assist in any small way. Could anyone please advise if this is even possible before I begin this quest? Any help or advice would be greatly appreciated. I really would like to help relieve her suffering. Many thanks
Re: Stage 4 tubiana - too late to do anything new post surgery some 30 years ago??
It's certainly not too late. You might try a doctor experienced in needle aponeurotomy (NA, also called PNF). Some can treat also advanced stages of Dupuytren's. Fingers won't get straight again because likely the joints already adapted to the bent status but NA can possibly open up the hand to an extent that it is much less debiliating. Your mother might afterwards wear a night splint for a while, this sometimes opens up the hand further.
Re: Stage 4 tubiana - too late to do anything new post surgery some 30 years ago??
Wow that's great thankyou Wolfgang. I've uploaded some photos to show how bad it is so as to confirm that your response still applies (even after surgery) and we can truly do something to improve her quality of life. That would be so amazing. Can they do it to feet also?? Thanks
Re: Stage 4 tubiana - too late to do anything new post surgery some 30 years ago??
I am not in a position to decide what is feasible and what is not. That can, of course, only be decided by the treating doctor. I could imagine that the little fingers might be a problem because they are generally difficult to treat and seem to have heavy scarring. The other fingers look easier to treat. If the doctor is experienced in NA and in surgery he surrely can advise what to do best where. Mini-incisions might be an alternative where NA is not feasible. Keith Denkler is based in San Francisco. Would that be an option? Keith is an expert in Dupuytren's.
NA is very rarely used for the feet but if there are strong cords, it might help there as well. People often have radiotherapy for Ledderhose Disease but that would not help with contracture.
Re: Stage 4 tubiana - too late to do anything new post surgery some 30 years ago??
I fully understand so thank you for your feedback, We live in France so the USA may be a long way to come!!! I will begin looking for options locally. Does anyone possibly have any recommendations? Thanks again.
Re: Stage 4 tubiana - too late to do anything new post surgery some 30 years ago??
Jeugy:I fully understand so thank you for your feedback, We live in France so the USA may be a long way to come!!! I will begin looking for options locally. Does anyone possibly have any recommendations? Thanks again.
Several options in Paris, where I live and where PNF/NA seems to have been invented and is covered by Social Security. Stef
[55, Dupuytren diagnosis 2006, RH contracture and PNF/NA 2014, radiotherapy RH 2015, LH 2017, night splint glove]