Hello again dupuytren sufferers.

I had my second surgical consult with Professor Alan Thursten, who is meant to be one of the best hand surgeons in Australasia. I asked him about all the treatments I have seen on this forum and magaged to get a good half hour of conversation out of him. Here is a summary of what he said about some of the procedures listed on this forum.

1.) Colagenase treatment

He had heard a lot about this new up and coming colagenase treatment and told me not to get my hopes up too much. Here is the reason why. Colagenase enzyme treatment will be a non-specific injectable drug, meaning that is does preferentially attack one type of tissue over another. It will "eat" ( for want of a better word") all types of tissue near the injection site - not just the diseased tissue. As a result this would make this type of treatment actually more damaging than having open surgery. You are more likely to damage tendons and nurves with collegenase injections than you are with open surgery.

2.) N.A
He said N.A was a good option for those who are in the early stages of Dupeytren's contracture (and those who have access to it). He was very clearly making a point that he did not think N.A was a good option for young (<55 years old) patients who had pronounced contracture. He said the recurence rate was much higher than most types of open surgery. He stressed that it is mostly only a good idea for patients who are elderly an have higher risks associated with open surgery.

3.) Open surgery

a.) Partial fasciectomy

This was the surgery he thinks is the best option (for a first surgery) for those patient who are under the age of 55 and have relatively aggressive contractures. It has a much lower recurrence rate than N.A.

b.) "Firebreak" Skin graft technique

This was the surgery he thinks is the best option for patients who have more severe agressive contractures and are still young. He takes a graft from the groin area and applies it over the joint(s) affected by the contracture. Contractures hardly ever recur under the grafted skin and so keep the joints working properly. The only problem with the grafting technique is that the skin grafted onto the hand is not as tough as normal hand skin and is therefore prone to getted cuts and blisters. He thought it may not be a good idea if you are a manual labourer as an occupation.

I will be having this skin graft procudure (my second surgery - my first skin graft) in attept to get a longer term result. I am 28 years old and first developed the contracture when I was 23. I hope this will help