I had NA by Dr. Eaton in Jan.'06 on my right ring finger. After 16 months, my finger is statring to contract again. Has anyone else had similar experiences?

Here are questions for Wofgang, Randy and the other experts.

Is there any downside with repeating NA (such as eventual formation of scar tissue or some other change in the skin or under the skin, increased frequency of recurrence)? Do we have any info on the number of times NA can be repeated without affecting the future outcome of a potential open surgery if one decides to eventually go the open surgery route? What is the minimum amount of time before one can repeat NA?

Donald

My guess is that the German surgeons who say this about NA don't actually *do* NA. According to the French, NA can be repeated indefinitely. Eaton, however, personally shared one caveat to that: With enough repetition the tissue can eventually begin to grow back in an increasing diffuse manor, making NA ineffective. At that point OS may become necessary.

Donald:

So, no, there is no reported downside to later OS, mostly just negative (and I think uninformed) opinions of those who don't do NA. I do have one thought on that, however. NA does not remove tissue. Therefore more and more aria of the palm can become involved. OS will remove *all* the current palmer tissue, effectively pushing the *reset* button on the disease. That does not prevent recurrence however, so for my money you go with NA until you can't any more.

Significantly, Eaton believes NA will be effective for well over 50% of all new patients for the rest of their lives. So, the odds are in your favor to give it a try. Certainly one or two rounds of NA is prudent in my book before upping the anti with OS.

For the best info on the web regarding NA see: http://www.handcenter.org/newfile23.htm

FYI, I just passed the one year mark for having NA and mini surgery (Dr. Denkler) on a pesky pip joint that had a previous extensive open surgery and reoccurrence of the disease. I am pleased to report that there is maybe 2 or 3 degrees of returned contracture in a year. In my book, thats pretty good. At that rate it will be several years before further treatment is needed. The bend came back faster after the previous open surgery. (actually two surgeries - long story). I have very good use of finger with about a 17 degree bend and am really pleased. 3 years ago it was over 50 degrees.

I emailed update pictures to Dr. Denkler who was also pleased results. He also made the following remarks:

"The overall results of NA have been very exciting. I am planning to report on my results in Stage IV Dupuyten's at the American Association of Hand Surgery Meeting in LA in Jan. 2007. The results with NA with these severe contractures have been suprisingly good."

Another report to look forward to. Thanks Dr. D.