When I first had NA by Dr. Denkler 3 1/2 years ago, it was evident that he is passionate about treating Dupuytren's patients. He did many surgeries before he found out about NA by reading an article from the 1800s describing it. He knew he could do it since he is trained in hand surgery and know the anatomy of the hands very well. He prefers to treat with less invasive treatments whenever possible. He has made presentations and they are posted on his website:
http://www.plasticsurgerysf.com/home/

- ASSH Hand Society Presentation of NA

- AAPS Presentation on Needle Aponeurtomy for Severe Dupuytren's

His board certifications are American Board of Plastic Surgery 1991 and Certification of Added Qualifications in Surgery of the Hand 1992-2002

This website and patients have educated many doctors about NA and RT. Xiaflex seems more well known, but then there was the pharmaceutical company's money promoting that as an option. For me, Xiaflex would also be a choice over surgery.

Just more info to consider.

Fully agree with Randy. Get 2nd, 3rd opinion, however many it takes until you are confident that you have gotten all of the information to make the best decision you can. You don't have to rush so much that you don't have time to get the information.

Randy_H:

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daleladue,

Getting Second Opinions are common. I'd recommend getting an opinion from a Certified Hand Surgeon (CHS) that is experienced in *all* the options available, not just Open Surgery and Xiaflex. That would mean he offers NA as well. If he doesn't do NA then by definition it would be impossible to get the full story. While OS might actually be your best option, get all the facts. Don't short change yourself.

PS: PT recovery from OS is *not* several weeks, as in 2-3. A month minimum. Been there, will personally avoid OS at all costs.

kay; I have had NA done twice on each hand. Both times with Dr Badois in Paris. Each time he did one hand then the other 3 days later. From my experience NA works for all conditions.

The comment "She recommends surgery rather than NA because of the lack of visible cord" doesn't make sense to me. I can't see how that is relevant at all. A lot of what my doctor does seems to be by feel. But then he has done more than 10,000 NA procedures over the past 15 years. Perhaps you should look for doctor with a lot of NA experience and perhaps french trained.

You recall that correctly. I wasn't a candidate for NA because a prominent or at least easy to reach cord was missing. NA means breaking a cord by puncturing it with a needle. I there is no distinct cord, NA is not quite feasible.

Wolfgang

Tusk:

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Dr. Denkler would know best. He is highly recommended. I've read where Dr. Eaton and others say there is a strong contraindiction (meaning a reason not to perform) for NA if there is no palpable cord, also tight or inadequate skin which might indicate diffuse skin involvement, heavy nodular involvement, and some PIP issues. Lack of palpable cord could be because of a deep location or nodular involvement. I also recall Wolfgang stating he wasn't a candidate for NA on one finger for one of those reasons. At least I think I recall that.