Gary, can you post the authority's name?

So, after looking on amazon.com, I assume you're either referring to Peter Brenner or Ghazi Rayan. Did he mention or claim to have any statistical data comparing the reoccurence rates between varying procedures?

I'll assume that means no. Gary, why is it so hard for you to directly answer a simple question?

Seems to me that the only way one could compare the reoccurence rate would be through statistical analysis of individuals that have had some type of medical intervention. That would mean polling practitioners & patients that have practice/undergone the various methods.

Since this board covers a fairly wide base. I'd like to pose the question: How many of you have been polled regarding your experience/reoccurence rate with NA?

Somehow, doubt that few if any have been.

I have read that information also. I think it is important to keep searching why these opinions differ. You refer to the AMA, it is not just the U.S. that has the opinion of faster recurrence with NA and fasciotomies. The 5 year rate of recurrence (greater than 50%) as stated by Badois (1993)for limited fasciectomies is not considered accurate by any published study to date. Even Moermans (1997) says, "the first operation, WHICH IS FOR MOST PATIENTS THE LAST ONE, must be as simple as possible to keep the complication rate very low." That is his reason for proposing segmental aponeurectomy when this operation is technically feasible. I have just been reading, "The Value of Fasciectomy in the Surgical Approach of Dupuytren's Disease", in the Romanian Journal of Hand and Reconstructive Microsurgery (2000). The results of their study: "Analyzing the results we observe that there were no relapses after 4 years follow-up of the 100 patients, and that the local minimal complications did not compromise the final results." While this was a smaller study than those done by Hueston, McFarlane,Moermans,Tubiana and others, it is supportive.

There seems to clearly be a place for NA as an acceptable (my opinion) procedure. Especially for people in Europe who wouldn't have a problem repeating the procedure several times. Also, for those whose conditions fit within the parameters of NA, and for those who are adverse to a surgical procedure. I personally (at this time), would lean towards Moerman's Segmental Aponeurectomy as the first procedure

I am trying to close the gap on why there is this diverse opinion in the medical community. I feel that it is a good learning exercise. More knowledge only helps. Besides Dupuytren's is a very interesting disease.

Gary

It still comes down to the question of the removal of diseased tissue and how significant that is in relation to recurrence.

I think you or anyone in the U.S. can get a simple fasciotomy in about any major city in the U.S. It is a very simple procedure and does exactly the same thing as needle aponevrotomy, it severs the cord and that is all.

My surgeon casually said he could do that right then when he examined the cord. I don't know if he was serious or not, but he did say that he usually did that procedure for older patients. In his experience, the recurrence for a younger patient was greater with just the fasciotomy, rather than the limited fasciectomy. The first surgeon (retired from surgery) that I went to for consultation said he could pop the cord right there in his office. Caught me off guard when he said that, then I realized he was retired and wouldn't/couldn't do it.