| Lost password
188 users onlineYou are not loggend in.  Login
About Needle Aponeurotomy for Dupuytren~sq~s Contracture
 1 2 3
 1 2 3
01/21/06 01:58
Tommy

not registered

01/21/06 01:58
Tommy

not registered

more aggressive

Don,

Could you elaborate on what you mean by "more aggressive"?

01/22/06 01:39
Randy H.

not registered

01/22/06 01:39
Randy H.

not registered

Dessert to the Sea

Don,

Recurrence, though certainly an issue with OS, is assumed by some to be to be a *far* greater issue with NA. The question is, exactly how much greater is the rate of recurrence with NA, and considering it's *far* lower rates of side effects and ease of recovery, is it the logical first procedure of choice?

At the end of the day, I'll bet it will comes down to the individual patient and how his/her particular hand(s) and disease respond to the needle or the knife. That being said, I would argue for at least one or two attempts at NA before upping the anti. What is to be lost by this approach?

Don, Eaton did his first NA less than 3 years ago, so your recurrence is a *tad* bit faster than you thought. Personally however, I would circle the runway with NA every two or three years indefinitely to avoid another OS crash-landing. That's me. Others have one OS, walk away, and are never heard from again.

It is sobering to hear the recurrence reports now that NA has had it's first North American test. But Don, I'll bet you dollars to donuts you'd go another round with Denkler in a few years than tangle with the knife in the hopes of putting on the breaks.

And what *is* "more aggressive". Inquiring Minds (from the Dessert to the Sea) *do* want to know.

RBH

06/28/06 02:13
Patrick

not registered

06/28/06 02:13
Patrick

not registered

Nearest MD doing NA to OHIO

I'm interested in getting Needle Aponeurotomy and was wondering if anyone knew of any doctors preforming the procedure in the Ohio or NE region of United States?

06/29/06 02:07
peggy

not registered

06/29/06 02:07
peggy

not registered

Dr. Pess in NJ

I had Charles Eaton in Florida do mine about a year and a half ago. I am in California and it was worth the trip to fly across the US to his office. His expertise is unmatched. I will do it again when the need arises again. I was more than satisfied with the entire experience.

09/02/06 02:53
Eddie 
09/02/06 02:53
Eddie 
Dr. Pess in NJ

Has anyone had the Aponeurotomy done by Dr. Pess in Eatontown, New Jersey?

11/09/06 01:31
Donald 
11/09/06 01:31
Donald 
Timing of NA

I heard from a hand surgeon that NA should not be performed during a time where there is DC growth/activity in the hand. One should wait until there is stability. Otherwise, DC is likely to come back very quickly. That would appear to make sense since it is my understanding that NA does not stop further growth (hopefully it does not encourage growth).
Have any of you heard similar warnings about timing of NA?

11/10/06 01:19
Anon

not registered

11/10/06 01:19
Anon

not registered

Stability

Donald

I'm afraid the information you were given about waiting for growth to stabilize before doing NA is quite wrong. Was your surgen an expert in NA? I somehow doubt it.
Even if there seems to be stabilizing just having NA could actually stimulate growth. Same with open surgery.
NA at anytime, with cortizone could be a way to go.

11/10/06 01:18
Randy H.

not registered

11/10/06 01:18
Randy H.

not registered

The Time is Now

Donald

Having followed the NA movement for some time I have *never* heard anyone suggest what your surgeon is saying.
What we have learned is NA should be done as soon as there is enough contraction to snap the chord. This is true even more so for the PIP, as it doesn't come back to straight as well as the MCP.

If anything, NA often disrupts Dups growth. After NA a large bump in the center of my palm was broken up and has become *completely* inactive. NA killed it (for now). Previously it was on the move.

Unfortunately there are some people who's disease is so aggressive that NA just can't slow it down. OS with skin graft is the best we have at present for such cases. However, I don't think there is a good argument for progressing directly to OS without exhausting NA first.

Get a second opinion from a CHS who is committed to NA as a first line of treatment.

11/11/06 01:19
Mark D

not registered

11/11/06 01:19
Mark D

not registered

When to Do N.A.?

Randy:

Are you aware of any guidelines about when one should have an N.A. done?

For instance, with a PIP joint contraction should one wait until the angle becomes 15 degrees? 30 degrees? Some other number?

If there are any such guidlines, do they vary from one finger joint to another?

Mark

 1 2 3
 1 2 3
Doctors   aestheticsurgery   Dupuytren~sq~s   FRENCH-TRAINED   contraction   Aponeurotomy   dupuytrenscenter   CERTIFIED   characteristic   crash-landing   percutaneously   contractures   aponneurotomy   understanding   centraljerseyhand   procedure   information   badois-dupuytren   aggressive   plasticsurgerysf