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NA on thumb/index webspace cord
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01/20/2013 21:19
humana 
01/20/2013 21:19
humana 
NA on thumb/index webspace cord

Has anyone had NA on a cord between your thumb and index finger in the webspace??

01/21/2013 08:21
richardt 
01/21/2013 08:21
richardt 
Re: NA on thumb/index webspace cord

I've had both webbings contracted by cords and nodules. On the left I had a skin graft. The left is now fine. The right I tried Xiaflex. Temporary relief but the cord came back with a vengeance, and within a year the contracture was worse than before the injection. I considered NA, but as I have an aggressive form of the disease, I chose a skin graft. Right webbing is now fine. While in the OR for the right webbing skin graft, the doctor completed an NA on a lateral band on my right thumb. The NA reduced tension on the cord, and the thumb no longer feels drawn to tightly to the base of palm, but the cord is still present, and much wider than before the NA, and there is still some fibered tension at the base of the thumb into the palm. I now think that the results of this NA experiment on my thumb would have been better had I chosen another skin graft at the base of the thumb rather than the NA.

01/21/2013 09:44
Seph 
01/21/2013 09:44
Seph 

Re: NA on thumb/index webspace cord

humana:
Has anyone had NA on a cord between your thumb and index finger in the webspace??
I haven't had cords in the web between thumb and index finger but I do have issues with nodules between thumb and forefinger. These have been treated with a combination of NA and cortisone. Hasn't completely fixed the problem but significant improvement.

01/21/2013 18:27
humana 
01/21/2013 18:27
humana 
Re: NA on thumb/index webspace cord

Thanks for your replies!! I've been trying to find out if anyone has had NA for webspace disease. I've been told I have an aggressive form of this disease and I've had 2 recommendations for open surgery. I also have email most of the doctors on the list from this website that perform NA to see if they even do NA for cases like mine.
Just as Seph states, I don't want to ruin my future options.

Edited 01/21/13 20:27

01/21/2013 18:52
callie 
01/21/2013 18:52
callie 
Re: NA on thumb/index webspace cord

richardt, what was the full procedure when you had the skin grafts? Was it the normal fasciectomy with skin grafts? Glad that it worked well for you. How about the recovery? How long ago was the surgery on your left hand?

Edited 01/21/13 20:53

01/22/2013 08:05
richardt 
01/22/2013 08:05
richardt 
Re: NA on thumb/index webspace cord

The procedure I had in the right thumb to index webbing was a full thickness skin graft. The graft was a square about 2 cm across and draped over the top ridge of the webbing such that one corner of the square pointed to the thumb, the opposite diagonal corner pointed to the index finger. The recovery time... 10 days to remove the stitches and another week until full use. I avoided lifting weights for 6 weeks as such activity puts stress on the webbing. As there were no knuckles involved, there was little swelling, no pain, and no fist making difficulty. I am right handed so I did substantially reduce the amout of handwriting and typing over a 2.5 week period. If I've any more contratures anywhere on my hands I will not use NA or xiaflex because I prefer a permanent removal of the contracture... but then I've a very aggressive form of the disease and grafts are all that stop it. I now wish I had saved 3200 dollars and not had the 250 microliter xiaflex injection on the right webbing the year before.

Edited 01/22/13 10:07

01/22/2013 11:54
humana 
01/22/2013 11:54
humana 
Re: NA on thumb/index webspace cord

Richardt, thanks for your information. Did you start with a cord in your webspace or nodule?

01/22/2013 15:28
richardt 
01/22/2013 15:28
richardt 
Re: NA on thumb/index webspace cord

Both a cord and nodule(s) were present in the webbing, like 3 beads on a short string. The xiaflex broke the cord at the injection site on the index finger side of the webbing, but did not alter the nodules. The cord reformed, and the nodules increased post injection. The graft done about 1.5 years later removed the 1/2 of the webbing ridge (index side) along with two of three nodules. The remaining webbing on the thumb side now contains one diffuse nodule, and remnants of the cord. The cord renmants still end at a fourth nodule at the base of the thumb, but the cord remnants do not contract anything.

My webbing is now decorated with several hairs, but not so many as to necessitate shaving. :)

01/22/2013 22:49
flojo 
01/22/2013 22:49
flojo 
Re: NA on thumb/index webspace cord

I had RT on webbing from thumb to forefinger in both hands. Right hand had nodules. Left had a cord running across the web and nodules right at the edge of the web. Webs were radiated as part of the extended margin of treatment.

01/22/2013 22:54
flojo 
01/22/2013 22:54
flojo 
Re: NA on thumb/index webspace cord

NA was done on cord in the web of right hand before I had RT. I'm not in a rush, but it's looking like I may want to have NA on cords in triangle of palm extending from left forefinger, thumb and wrist. One cord is right at the edge of the web.

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