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Can I leave the Dupuytren's Contracture untreated?
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11/24/2020 05:45
Ravi 
11/24/2020 05:45
Ravi 
Can I leave the Dupuytren's Contracture untreated?

Hi! I am Ravi from India, and new to this platform. I have been diagnosed with having Dupuytren's Contracture, having affected my pinky finger and the ring finger on the left hand. Both these fingers are already bent in as they say, in the advanced stage.

This is an extremely rare disease in this part of the world, termed as rarest of thre rare..

Staged Percutaneous Needle Fascieotomy has been recommended by my Doc, to be followed by the Open Fascieotomy subsequently, probably after 2 or 3 weeks from the end of the last Staged Percutaneous Needle Fascieotomy.

As the Doc says that there are 70% chances of recurrence, can any body please guide me:
1. If we leave the hand in as is where is condition, and live with it, does it create any other complications?
2. Can I just go for the Staged Percutaneous Needle Fascieotomy and drop the plans for the Open Fascieotomy?
3. Is there any other option other than surgical intervention at this stage?

Will be grateful if anyone could share some views on this

Thanks!

11/24/2020 10:19
wach 

Administrator

11/24/2020 10:19
wach 

Administrator

Re: Can I leave the Dupuytren's Contracture untreated?

Hi Ravi, here are my 5 cents:

1. If we leave the hand in as is where is condition, and live with it, does it create any other complications?

A: probably no other complication, except that the contracture may progress and the skin in the contracted area might get inflammed and infected because it is no longer exposed to air and difficult to keep clean.

2. Can I just go for the Staged Percutaneous Needle Fasciotomy and drop the plans for the Open Fasciectomy?

A: yes, definitely an option. But you will probably need to wear a night splint after needle fasciotomy, at least for about a year. Otherwise the contracture might return quickly. Needle fasciotomy can be repeated several times, different to surgery, where already the first repeat is difficult and a second often impossible due to scarring and limited blood circulation.

3. Is there any other option other than surgical intervention at this stage?

A: collagenase injection https://www.dupuytren-online.info/dupuytren_collagenase.html would have been an option but the vendor made it extremely expensive. Not worth pursuing anymore. You might also try a dynamic hand splint (see example at the bottom of https://www.dupuytren-online.info/dupuyt...-splinting.html ). You will need to work this with your hand doctor because such splints are usually not readily available.

Wishing you success!

Wolfgang

11/24/2020 11:05
Ravi 
11/24/2020 11:05
Ravi 
Re: Can I leave the Dupuytren's Contracture untreated?

Thanks!
One more question, if you can share your opinion please! after the PN Fasciotomy, can I avoid going for the Open Fasciotomy completely since results do not seem to be very encouraging. PN Fasciotomy backed up with the Splint seems to be good from the link referred by you!

As this is an extremely rare disease here in India, I am though fortunate to have a Doc who has done his Fellowship in Hand Surgery from England and it took him fraction of a second to identify the disease by name. But then he did not discourage me for the Open Fasciotomy. According to my Doc, he recommends Staged Fasciotomy, in probably 2 or 3 sittings, and then the Open Fasciotomy.

So, need to take a final call regarding the Open Fasciotomy, whether I should or should not.

And yes, I have felt very much at ease going through your response. Thank you once again!

Regards

11/24/2020 11:19
spanishbuddha 

Administrator

11/24/2020 11:19
spanishbuddha 

Administrator

Re: Can I leave the Dupuytren's Contracture untreated?

Ravi:
Thanks!
One more question, if you can share your opinion please! after the PN Fasciotomy, can I avoid going for the Open Fasciotomy completely since results do not seem to be very encouraging. PN Fasciotomy backed up with the Splint seems to be good from the link referred by you!

As this is an extremely rare disease here in India, I am though fortunate to have a Doc who has done his Fellowship in Hand Surgery from England and it took him fraction of a second to identify the disease by name. But then he did not discourage me for the Open Fasciotomy. According to my Doc, he recommends Staged Fasciotomy, in probably 2 or 3 sittings, and then the Open Fasciotomy.

So, need to take a final call regarding the Open Fasciotomy, whether I should or should not.

And yes, I have felt very much at ease going through your response. Thank you once again!

Regards
Hi Ravi

I agree with Wolfgang. With regards to your new question why not decide on the surgery after seeing the results of the PNF/NA. They may be good enough, for a while.

Best wishes SB

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