Cryosurgery (also called cryoablation, cryotherapy or simply cryo)
Cryosurgery is occasionally used to treat Morbus Ledderhose (Ledderhose disease). A probe is inserted into the diseased tissue and the nodule and the surrounding tissue is deeply frozen, typically with liquid Nitrogen, more recently also with thinner probes using Argon or other gases. Cryosurgery "will destroy nerve tissue by causing extensive vascular damage to the endoneural capillaries or blood vessels supplying the nerves" (anthem.com) and thus kills the nerves' ends in this area. The purpose is to reduce pain and shrink the nodules.
Literature documents only a single case where a Ledderhose patient was treated with cryotherapy. In that case the treatment was successful and the nodules reduced in size. We are here reporting three more recent and successful treatments of Ledderhose disease, including pictures that one of the patients (David Adams) shared with us cryotherapy details. Another case is presented by Dr. Steven Goldstein on http://www.cryosvs.com/Cryotech-PlantarFibroma.pdf.
For further information on cryotherapy you might e.g. have a look at cryotherapy_overall or at the cryotech web site. Because we are not yet aware of studies with good statistics regarding cryotherapy of Ledderhose or Dupuytren, and we have no indication of side effects or long term results except the general ones of cryotherapy, we consider this therapy for Ledderhose or Dupuytren as somewhat experimental, although cryotherapy itself has been in use for many years and side effects are usually minor.
For Dupuytren's contracture we doubt whether fingers can be released and we would be concerned about the side effects of killing nerve ends in the hand's palm or the damage of arteria which might result in the loss of fingers.
For treating feet (Morbus Ledderhose) recent results of cryosurgery are more encouraging. It seems that nodules can be reduced in size though they probably will come back. Those who plan having cryosurgery might consider the advice of a patient (David) who already had several cryos for Ledderhose: "The doctor treated nodules by moving the probe under the skin to treat nodules as much as 3 inches away. That was a big mistake. If you are going to have cryo, always have them go straight down into each nodule. Almost no bruising if they do this. More wounds, but they are small and don't even scar."
Recently, at the Dupuytren conference in Miami 2010, results for cryotherapy of Ledderhose were presented by Terry Spilken (presentation on youtube). Results of that conference will be published as a book by Springer in 2011.
Cryosurgery or rather the according devices have been approved by the FDA to be sold within the USA for a variety of applications, like e.g. treatment of skin fibroma (see e.g. FDA_cryo_devices). Cryosurgery has not been specifically approved by the FDA for the treatment of Ledderhose disease but this might or might not fall in the category of approved pain relief (Dupuytren Society can't judge that).
Don't confuse cryo surgery/cryotherapy, which is using a probe to guide the liquid nitrogen to the diseased tissue, with spraying liquid nitrogen onto the skin (like for treatment of warts). One patient reported this application to Ledderhose but we haven't seen longer term results yet. If this technique works at all, it is probably restricted to small nodules that are located directly under the skin. We would also be concerned about larger skin damage.
Page last modified: 04/21/2011