I am a 72 year old white man with Dupuytrens. In the last ten years I have had 4 procedures done with NA. I had the first two done by Dr. Eaton, then after he closed his practice I tried a different doctor in NC that I was not happy with. Two years ago I had the NA done again by Dr. Bourland in Memphis, TN. Now he has retired, so it seems that I cause Doctors to close their practice. I was very happy with Dr. Bourland, but again I had to find someone else.
Ok so I went to see Dr. Kay Kirkpatrick in Atlanta Ga. Now I will say this to begin with, I was impressed with her knowledge of Dupuytrens. After checking my hand, she said that since I had already had 4 NA procedures done, that she would be very hesitant to do another NA. She said that each NA procedure causes scaring of the cords and it makes it lot more difficult to do the NA without doing nerve damage. Now she said that even though she did not feel comfortable doing another NA, that if that is what I wanted, she would do it. She suggested hand surgery, which just scares me to death. I have 3 questions.
(l) Anyone else heard that NA becomes more dangerous with each time?
(2) What is your opinion on hand surgery?
(3) Would like to hear opinions on what you would do if you were in my situation?
My pinky finger is a good 45 degrees, the ring finger is app. 30 degrees. The pinky finger was too far gone even the first time I saw Dr. Eaton, so this finger has never been straight using NA. The NA has always improved it, but never straight.
Thanks for any information you might be able to provide.
Tigerplay

There is a limit to the number of times NA can be repeated, usually due to the build up of scar tissue, nodules and cord regrowth. 'Dangerous' is the wrong description, difficult more appropriate. Too difficult now for you? Every case is different though, but if your doctor is wary I would be too. Like econn suggests investigate if Xiaflex is an option for you, and again do due diligence on the doctor. Like you I would want to delay hand surgery, but yet again there are lots of good reports too with good outcomes to counter the the many bad reports you hear. It seems the skill and experience of the surgeon, and the after care they provide with a physio team is of the utmost criticality here.

Just in case you haven't done that yet: you might also check the list of the British Dupuytren's Society
http://www.dupuytrens-society.org.uk/tre...-organisations/ . Prof. David Warwick (Southampton), who is listed under Needle aponeurotomy (PNF), also has extensive experience with Xiapex.

BTW, in Europe the medication for injection is named Xiapex. For whatever reason the original name Xiaflex was not approved for Europe.

Wolfgang

tigerplay:

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First I would like to thank Econn and Spanishbuddha for their opinions.
After I posted yesterday I started looking at the Ziaflex option. I found three doctors in my area that are doing that and all three seem to be very good doctors with many years of experience. Not sure if I would be a candidate for Ziaflex, but am certainly going to pursue that option.
Thanks again
Tigerplay
PS My doctor yesterday did not mention the Ziaflex option, so I assume she does not do that.