Hi Ravi, here are my 5 cents:

1. If we leave the hand in as is where is condition, and live with it, does it create any other complications?

A: probably no other complication, except that the contracture may progress and the skin in the contracted area might get inflammed and infected because it is no longer exposed to air and difficult to keep clean.

2. Can I just go for the Staged Percutaneous Needle Fasciotomy and drop the plans for the Open Fasciectomy?

A: yes, definitely an option. But you will probably need to wear a night splint after needle fasciotomy, at least for about a year. Otherwise the contracture might return quickly. Needle fasciotomy can be repeated several times, different to surgery, where already the first repeat is difficult and a second often impossible due to scarring and limited blood circulation.

3. Is there any other option other than surgical intervention at this stage?

A: collagenase injection https://www.dupuytren-online.info/dupuytren_collagenase.html would have been an option but the vendor made it extremely expensive. Not worth pursuing anymore. You might also try a dynamic hand splint (see example at the bottom of https://www.dupuytren-online.info/dupuyt...-splinting.html ). You will need to work this with your hand doctor because such splints are usually not readily available.

Wishing you success!

Wolfgang

Ravi:

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Thanks!
One more question, if you can share your opinion please! after the PN Fasciotomy, can I avoid going for the Open Fasciotomy completely since results do not seem to be very encouraging. PN Fasciotomy backed up with the Splint seems to be good from the link referred by you!

As this is an extremely rare disease here in India, I am though fortunate to have a Doc who has done his Fellowship in Hand Surgery from England and it took him fraction of a second to identify the disease by name. But then he did not discourage me for the Open Fasciotomy. According to my Doc, he recommends Staged Fasciotomy, in probably 2 or 3 sittings, and then the Open Fasciotomy.

So, need to take a final call regarding the Open Fasciotomy, whether I should or should not.

And yes, I have felt very much at ease going through your response. Thank you once again!

Regards