The "snap" or pop of the cord should not be painful because of the nerve agent that is injected beforehand. Secondly, the increase in movement is always immediately apparent. If you have lost that increase in movement it would be because of *very* rapid recurrence, which is possible. Is the chord back? If so, you would be among the few number of cases where NA is ineffective and Open Surgery will be the next step.

Getting a 2nd opinion from an NA doctor wouldn't hurt, however. In my experience the need for this this would be a first, however

Thanks Randy and Dave for your quick answer and close attention to my case.
I'm french and I had NA in Paris, in the historical Hospital Lariboisière where NA was first developed if I don't make a mistake..... My impression is that like in any public hospital in France now, doctors are too busy and don't really pay much attention to patients. Ten minutes for each so there's not much time to talk...
So the doctor cut the cord on the front of my little finger (the palm side) and I feel it's more on the side of it. So may be there's a way to start it all over again ? I would appreciate any recommendation about a very good NA doctor here in France if you know any...

Dave, you are mentionning braces, night splint and stretching after NA. Nobody gave me any information about this at the hospital. Just a bandage for three days and two weeks of care and that was about it.

Anyhow I'm going to wait a couple of month before another appointment but what do you mean exactly when you say that tissues reset their length ?

Luc,

Dr. Pess wrote me a prescription for therapy and strict instructions on the type of therapist to look for. I was lucky enough to find a most talented woman near my home outside Philadelphia. For several weeks, I went in twice a week. They would do heat, ultrasound and massage therapy. Should would intrically slide my knuckle around in order to loosen the capsule of tissue around the knuckle. She also built me a custom-made brace. It's a formed piece of plastic that fits around the back of my hand. From the back, a cantilever rises. Through the cantilever runs a wire that connects to a loop around my finger. I pull pack on the wire like a pulley and secure the strap will velcro. She tells me the idea is to not put full stretching pressure on the finger, but rather a slight constant pressure. This causes the tissues in the figure to "reset" their length.

My finger was at 95 degress before the NA. Dr. Pess got me opened up to 25. The therapy opened me up to as much as 15 although it's come back closer to 25 since I stopped going. I should add that I made about a dozen visits and even with much of the therapy covered by my medical insurance, I still paid $15 a visit.

Two other things I learned. One, there are specific stretches to do for the hand and they aren't as simple as pushing your hand flat to the table. That puts pressure in all the wrong places. Also, it's important to do strengthening exercises for the tendon on top of the finger. As you finger bends due to DD, the tendon gets stretched out. Think of a rubber band stretched over the edge of a table. I do extensions against pressure with my finger. Think of lower leg extensions like you would do to strengthen your quad muscles around the knee. I do that daily with my finger.

The therapy was definitely worth it. And they were as amazed with the NA as I was. She had me describe it to her and her colleagues in great detail. I'm definitely going back when I have my other hand done in two weeks.

Hope that helps. Bon chance.

dave

Thank you Dave for the technical details about your therapy after NA, it will help me in the future and probalby a lot more people reading your message. I didn't think that NA could work for fingers bent up to 95. I'm very happy that you got your finger back. Stretches are definitely what I need, I guess, to strengthen the operation.

Thank you Wolfgang and Marjorie for your indications. Of course I knew about Dr Lermusiaux but never thought I could reach him, there's still a lot of people coming from abroad just to see him. There must be a long waiting list but anyway I can try. And if you need my help to contact Lariboisiere to develop the Dupuytren Society (which is my best source of information) that's the least I can do to thank you. I just want to point that I don't live in Paris but happen to go there once in a while and also that I am not involved in the medical world. But I'll do my best to translate your needs.

Thanks to you again Marjorie (a lot of nice people here to thank, the Dupuytren family ?). Your story confirms my impression about Lariboisiere and I would add that I don't complain about doctors and their skills, they're with no doubt great professionals. They just run after time and means in public hospitals and give certainly more attention in private practice. I'll check that.

Bonsoir à tous.
Luc

I think it could be said without complaint that Dr. Lermusiaux has eased the suffering of Dups patients more than any single individual in the last 100 years. This in terms of the number of people treated and the number of Doctors trained. Quit beyond this would be his development of NA itself, now closing in on 40 years ago. Not a cure by any means, but the most significant alternative to Open surgery so far in our life time. Collegenase by BioS may well eclipse NA's effectiveness, but not close to the cost / benefit ratio. I would love to meet the Man.