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ANZJS NA paper 2014 by David Hunter Smith
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04/12/2014 02:55
FOGG 
04/12/2014 02:55
FOGG 
ANZJS NA paper 2014 by David Hunter Smith

Apologies if this paper already exists in the forum but I thought it would be of interest to readers.

It is a Dupuytren’s contracture: an analysis of outcomes of percutaneous
needle fasciotomy versus open fasciectomy by David Hunter Smith

Interesting reading - lets hope more doctors and surgeons take notice pull their heads out and start practicing.

Steve

04/12/2014 04:46
wach 

Administrator

04/12/2014 04:46
wach 

Administrator

Re: ANZJS NA paper 2014 by David Hunter Smith

This is the Abstract of the paper in ANZJS

http://www.ncbi.nlm.nih.gov/pubmed/24438029.

Last year's winner of the International Dupuytren Award was

Annet van Rijssen et al.
"Five-Year Results of a Randomized Clinical Trial on Treatment in Dupuytren’s Disease: Percutaneous Needle Fasciotomy versus Limited Fasciectomy"
Plast Reconstr Surg. 2012 Feb;129(2):469-77

Abstract: http://journals.lww.com/plasreconsurg/Ab...l_Trial.30.aspx

04/13/2014 09:42
BRIANB 
04/13/2014 09:42
BRIANB 
Re: ANZJS NA paper 2014 by David Hunter Smith

Thank you .. very interesting regarding N.A. guess I have been one of the lucky ones .. N.A 5 + years and still doing fine.

Would have been curious how many of the folks in the study wore an appropriate splint and for how long.

04/13/2014 10:23
wach 

Administrator

04/13/2014 10:23
wach 

Administrator

Re: ANZJS NA paper 2014 by David Hunter Smith

The effect of splinting was not tracked by van Rijssen et al. because they thought that compliance is difficult to assure. Accidentially I was able to review questionnaires from another doctor and did not see a significant effect of splinting after NA. Data were not reliable enough to publish but I was surprised because I had expected at least some effect.

It might be that NA is similar to Xiaflex with regard to recurrence. This year's winner of the Dupuytren Award, Clay Peimer,http://www.dupuytren-online.info/dupuytren_award.html, found that patients after collagenase injection are falling basically into two groups. For one group the result seems to be lasting fairly long (nearly no change over 3 years) while for the other group the recurrence is starting nearly immediately. It may still take a while until the second group needs treatment again but the quick onset is evident. It is the first time that this was reported and the effect was visible only because of careful and frequent tracking over several years. It is still unclear what causes the difference between the two groups.

If NA exhibits similar behavior then you probably belong to the first group. You were lucky, enjoy!

Wolfgang

BRIANB:
Thank you .. very interesting regarding N.A. guess I have been one of the lucky ones .. N.A 5 + years and still doing fine.

Would have been curious how many of the folks in the study wore an appropriate splint and for how long.

04/13/2014 21:27
BRIANB 
04/13/2014 21:27
BRIANB 
Re: ANZJS NA paper 2014 by David Hunter Smith

Been strapping on splints ... both hands every night for years... I am sick of it .. and so is my wife ....

But I am sooo hestitant to go without them ... no easy answers to this strange disease ..

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