Danch,

Surgery is trauma. Trauma can aggravate Dups. Your theory is reasonable. When the old BioS From had a lot of people talking abut their current surgerys (we don't hear abut people's current surgery too much any more, do we.) Many felt that the surgery itself triggered more disease. That was their feeling. However, I know of no study that links the two so that was controversial. But during most Dups OS the surgeon will open the hand looking to remove all the disease tissue he can find. "Clean it out" my surgeon said. Why do they do that? Any one correct me if I'm wrong, but I believe the idea is that if they leave any diseased tissue behind they know the trauma from the surgery itself could trigger it, whereas before it was just slow growing.

I am a semi-pro drummer. I was asked at one point to switch to congas to have another drummer play 50% of the time. I had no training on congas and I hit them way too hard to the point that the nails on my fingers caused beading on other fingers. Some conga players actually tape their fingers. I would come away with my hands hurting and I did wonder if I could hurt them doing this. I believe I got my answer months late.

I don't play congas any more.

I'm not saying to baby our hands. I will play a small hand drum from time to time but lightly and not for too long. Not so they hurt at all. Not close to clapping like an idiot for 3 encores and your hands do hurt. Buy hey, we need to go about our lives. Just don't do anything that makes them hurt. Pain is there for a reason. If you have Dups you need to listen to you hands.

My contraction was of the little finger only. There were no other problems and no lumps or bumps on my palm. However, I woke up from OS to discover that my hand had been opened up from the right side at the pinkie all the way to my first finger on the left. So my palm was completely opened up so he could look all through it for diseased tissue though none was discernable before surgery.

I asked him about my chance of recurrence and that's when he sad that he had "cleaned me out pretty good" so I should be OK.. So with OS, if you are going to go in there you have to go all the way and look everywhere for problems. With NA you just deal with the contraction and them leave well enough alone.

Shortly after surgery I developed a slight web contraction from my thumb that had not been there before. I was not upset that he had not opened up my palm at the base of my thumb. That would have only made my flair reaction to the OS worse.

I've had no recurrence after NA. And should that happen I'll know what to do. After I showed the correction Eaton had done on my other hand 2 years later he was amazed there wasn't nerve damage and that the correction was as good as it was. (He had strictly warned me against doing NA previously) He then recommended that I avoid OS at all costs and just do NA.

Funny, I was thinking the same thing.

I guess he knew a bad case when he saw one. Yes, I took the OS bullet and the Doc knew NA was my only way forward. No more trauma from surgery.

Randy_H:

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Danch,

Surgery is trauma. Trauma can aggravate Dups. Your theory is reasonable. When the old BioS From had a lot of people talking abut their current surgerys (we don't hear abut people's current surgery too much any more, do we.) Many felt that the surgery itself triggered more disease. That was their feeling. However, I know of no study that links the two so that was controversial. But during most Dups OS the surgeon will open the hand looking to remove all the disease tissue he can find. "Clean it out" my surgeon said. Why do they do that? Any one correct me if I'm wrong, but I believe the idea is that if they leave any diseased tissue behind they know the trauma from the surgery itself could trigger it, whereas before it was just slow growing.

I am a semi-pro drummer. I was asked at one point to switch to congas to have another drummer play 50% of the time. I had no training on congas and I hit them way too hard to the point that the nails on my fingers caused beading on other fingers. Some conga players actually tape their fingers. I would come away with my hands hurting and I did wonder if I could hurt them doing this. I believe I got my answer months late.

I don't play congas any more.

I'm not saying to baby our hands. I will play a small hand drum from time to time but lightly and not for too long. Not so they hurt at all. Not close to clapping like an idiot for 3 encores and your hands do hurt. Buy hey, we need to go about our lives. Just don't do anything that makes them hurt. Pain is there for a reason. If you have Dups you need to listen to you hands.

Danch, my man. Dial it down a bit.......You will be ok.

Look, you don't need surgery. Not now, and in all probability never. An in the very small chance you ever did, don't read my case as normal. I'm the outlier. 99% of people doing OS for the first time do better than I. That's not to say I'd ever advise OS unless NA and/or Xiaflex were not effective (almost never).

So, no Shamans, all right? (though some thought Eaton was one for a while :)

I saw a video of Dave Matthews' drummer wearing golf gloves while playing. Went out an bought a lefty and now the Dups surgery has no effect on my playing at all. Look, I freaked out too, OK? It's normal because you don't know what might happen.

If you want to do something, look into RT. Otherwise, don't fret and just hang out with us.

Randy,

You said (I believe) that you had a 45 degree contracture of only the little finger. Everything I have read pointedly states that the McCash method should primarily be considered for multiple contractures and severe cases. Your situation as you described is not considered generally for using the McCash method. There are about 10 pages describing the McCash method in Tubiana's book.

This is what is surprising to me, almost every textbook concerning surgery for Dupuytren's agrees with Tubiana, "The author(Tubiana) agrees with Schneider(1991) who, after performing many open palm operations, has restricted its indications to multiple and severe contractures of the MP joints that, when released, would leave a deficit in palmer skin for closure."(Dupuytren's Disease, Tubiana, pps. 184-185)

"This technique should therefore not be regarded as the standard procedure for Dupuytren's disease. It is certainly not suited for uncooperative patients, who would not be able to cope with the postoperative regimen."

"It is not best indicated in single ray lesions, where closed techniques will lead to a faster result."

Also, from Eaton:

"This study of the McCash open palm technique confirms that the rates of complications (21%) and recurrence (33% at 2 1/2 years) remain issues even the hands of experienced surgeons:" http://www.dupuytrenfoundation.org/DupPDFs/1994_Cools.pdf
POSTED BY EATON.MD AT 4:23 AM