I am a 50 year old Anglo male who has the onset of DC with minor contracture at this time. Like everyone else on this board, I am against invasive surgery when there is NA, the promise of injectibles, etc. Therefore, I had cancelled my first appointment with a ortho hand surgeon, but decided to make a second one since I would get an official diagnosis and was curious to hear his side of the story.

I went in the office with a chip on my shoulder waiting to see an arrogant patronizing guy with a scalpel in his hand. The doctor turned out to be quite different.

IN NO WAY WOULD I ADVISE SURGERY for this disorder, but I found out in most cases, neither would he. He went on to tell me that while he sees DC more than anything else, it is by far the most difficult procedure he has to do and is "humbled" every time he feels a procedure must be done. Basically, that is right before amputation is necessary (my words not his, but I am trying to make a point here).

DC is basically some auto-immune (sp) reaction to some trauma that has NOT happened. They don't know why. When a surgeon CUTS, he causes more trauma which creates MORE DC. This surgeon knew that. Not only that, it makes his work even more of a nightmare if he has to do it again.

He also gave me some additional info. (and told me to "write this down") assuming that he may not in fact be the one to "do the work". Bottom line, if you feel you have no other alternative to surgery IN YOUR CASE, make sure the surgeon has been in a 12 month HAND FELLOWSHIP training program (anyone can say they are an ortho hand surgeon) and also, NEVER allow your doctor to take BIOPSIES. (again, this is trauma which will make it worse).

Again, I am NOT PRO SURGERY...I would be the first one on a plane to France or to get injections, but I am just sharing information from a more conservative surgeon.

It would be better for all concerned if you were to vent your frustrations elsewhere. It appears that your latest ranting was set in motion by the positive informative postings of Richard, Dave, PS and Randy. All they did was explain their personal feelings and history concerning conventional surgery and/or its effects on their bodies.

How many more surgeries would POOR RICHARD (pun intended) have to undergo if it weren’t for the availability of Aponevrotomy in Europe? The needle procedure is currently the ONLY viable relief available to us at this time. There is virtually no resultant trauma from the procedure and can be repeated as required.

And yes Sean; SURGERY does BEGET SURGERY. Have you taken the time to read Kris’ and my FLARE posting available for view at Walt’s site? Read it; you may learn something.

http://jvm.com/wstagner/dlinks.htm

People suffering with Dupuytren’s and related ailments visit the forums to garner the type of information not available from the medical establishment. The posters happen to tell it as it is without resorting to your type of rhetoric.

I must however say you have accomplished much: you have driven most of the knowledgeable providers of information from the forum. They have resorted to e-mail as a means of dispensing direction to the uninformed without your constant interference. You are thereby depriving other viewers of much needed information.

Sean,
It is IRONIC that your soapbox for pushing surgery is
provided by Biospecifics, who you know is researching non-
surgical solutions for dupuytrens disease. Also IRONICALLY
you have posted that J.P. Moerman's segmental aponeurectomy
would be the best overall procedure. You have referenced
him many times. Has it escaped you that in his website,
under history, then under conclusions he states: "the
surgical approach of Dupuytrens disease has swayed from the very simple closed fasciotomy to the very aggressive radi-
cal palmar fasciectomy. The less traumatising techniques
were often found insufficient to correct the contracture
and to bring lasting improvement. The more agressive
operations were developed on the unfounded hope that recur-
rences could be avoided. This has never been proved and
these techniques were responsible for a great number of
complications." (http://www.ccbel.org/History.html)
Sean we intend at any cost to promote to the insurance
companies who we believe will provide the greatest change
in attitude to your medical community, the need for NA and
various cost savings and more humane treatments. As a matter
of fact, we have commissioned our advertising/PR agency to
educate the insurance companies about alternatives to sur-
geries for dupuytrens disease. Change will occur.

Randy,
There are many studies that have shown a correlation of hand trauma and DC. Trauma can be a trigger, but not always. There are many people who contract DC without trauma. That is why DC is interesting there is not a uniform pattern. Often there is no pain with DC, but there are many who complain about pain with DC.
Also it is not unusual for both hands to become affected at approx. the same time. The several people who I know with DC got it in both hands about the same time, give or take a year or two.

Scott:

There is not as much controversy on this forum as it may appear at first glance. There are just a few fellows with strong minority opinions who make it their business to defend them. Dups is very unpredictable. That's why when I say I'm convinced that the trauma of the surgery to my left hand triggered the immediate onset on my right, some are then able to say it was going to manifest at that exact time even if I had delayed the surgery. If you believe that then I've got some great lo-cost swamp land I'd like to tell you about.

However, surgery doesn't always trigger more disease, as there are some voices who say it NEVER does. I don't know what % of the time it does. It may be LOW. But to say 00.0% is just plain silly because: "There are many studies that have shown a correlation of hand trauma and DC." If surgery isn't highly traumatic to the hand, I don't know what is. The opposing view is self negating.

But Scott, regardless of this in house debate, you don't have a choice. Find the best surgeon you can get. He will know not to operate until you have a finger contracture of at least 30-40%. Don't let them touch you before that. There is no need. But don't wait for it to get much over 50%. The fingers are more difficult to straighten. Know this: You could easily have one surgery and be done with it for long time. Hopefully by then effective non-surgical options will be available. God bless and keep your chin up.