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Comparing the techniques in NA
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06/01/2004 23:07
Jim L.

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06/01/2004 23:07
Jim L.

not registered

Comparing the techniques in NA

I have heard Dr. Eaton uses a 25 guage needle while Dr. Badois using 16 guage....any thoughts on what the benefits/risks may be in using different size needles? Maybe one way has better long term results?

06/01/2004 23:53
Brian

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06/01/2004 23:53
Brian

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On the one hand...

Dr. Badois peformed NA on my right hand and I thought
that he used a 25 Ga. needle at the time. I remember
commenting to my wife that I use 30 Ga. needles for
local anesthetic, and many prefer 25 Ga. because it
is less liely to deflect (it is stiffer.) 16 Ga. would
be a very large bore needle. I think I would have noticed
the large entry wounds; mine were small pinholes. Perhaps
the diameter is dependent on the thickness/toughness of
a cord. Some cases may require "beefier" instrumentation.
One consideration is nerve damage. Small bore needles deflect; they also do less trauma when penetrating a portion of a nerve bundle (fewer fibers are severed.)
Large needles might do more damage than smaller bore needles. Personally, I suspect that the diameter/bore is
a variable that skill, experience and cicumstances influence. One does not house paint with China bristle
art brushes; nor does one use a 4" brush for detail.
I suggest asking Dr. Eaton and Dr. Lermusiaux if there
exists a preference or recommendation. I suspect that the
answer is, ca' depends.

06/02/2004 23:31
Dr. Wicks

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06/02/2004 23:31
Dr. Wicks

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Gage of Needle used in performing the NA procedure

Brian,

A 25 gage is the size of the needle used in performing the Needle Aponeurotomy in most cases. The reason for this is that it is a small needle that slides around tendons. It is about one-third the size of tendons. etc. As for the Digital Nerves, the physician ask if you feel an electric shock let me know immediately. Reason being the physician knows he/she is near a nerve, and will turn directions with the sawing motion in a different direction at once. Also, the physician will ask from time to time if you feel any numbness in the end of fingers. If one feels numbness the doctor can't get proper feed back from the patient. During the procedure the physician will from time to time stop and ask you extend your fingers and then bend to the palm. This let the doctor know that things are going well. The doctor can feel the resistance of the cord(s) with the needle and commence the cutting of the cord(s) with the bevel edge at the end of the needle. As the cord(s) are tough the needle has to be changed frequently as it becomes dull. You see, one actually assist the physician by feedback that helps the doctor do the NA procedure. Of course there is more.

06/04/2004 23:24
Brian

not registered

06/04/2004 23:24
Brian

not registered

J~sq~ai oublie~sq~ tout!

My NA was painless, uneventful and 99.9% successful.
I made my personal choice of practioners based upon
training, experience, recommendations, location.
Dr. Badois had my complete confidence and met or
exceeded my espectations. I trusted his judgement
in armamentarium selection. Dr. Eaton is without
doubt a very competent hand surgeon gaining experience
with each case. While nerve/tendon trauma is a real
possibility, it is a very unlikely outcome when an
experienced NA practioner performs the procedure.
Dr. L. and the Lariboisiere staff are the "A" team.
That does not impugn talented US newcomers. For now, and
the near future, I prefer consulting with the most experienced practioners in the world, and their proteges.
That is just me. Everyone gets to make their own choices
unless third parties get involved. Call your HMO, PPO for
a referral. Needle Apo-what?

05/03/2005 23:30
The Hammer Head

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05/03/2005 23:30
The Hammer Head

not registered

Badois vs. Eaton

It is Eaton for me. He did a great job on my bent finger. I will return to Dr. Eaton when it bends again.

05/03/2005 23:30
Randy H.

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05/03/2005 23:30
Randy H.

not registered

NA Techniques

Eaton prefers to break a cord in as *many* places as possible, whereas according to him, "The French are more likely to go for *one* big break, rather than multiple." I asked "Is this one of the points of departure from the French that differentiates the 'Eaton Method?'.....

'Yep'"

05/04/2005 23:16
Gary M Pess, MD

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05/04/2005 23:16
Gary M Pess, MD

not registered

NA Techniques

Every surgeon modifies the way they perform a procedure after they are taught that procedure. I had the opportunity to work with 4 of the French Docs and each of them did the procedure slightly differently. All of us (French Docs, Eaton and I) use a 25 gauge needle. A larger needle significantly increases the risk of tendon and nerve injury, especially in the finger. The cord is carefully divided and extension pressure finished the release.

SIncerely,
Gary Pess, MD
http://centraljerseyhand.com

08/13/2005 23:29
Caroline

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08/13/2005 23:29
Caroline

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Contacting Dr. Badois

Dear Brian,
From what I've read Dr. Badois is a good doctor for DC.
Have you got contact details for him ? I cannot find any.
Thanks.
Caroline.

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experience   centraljerseyhand   possibility   techniques   instrumentation   physician   significantly   consideration   procedure   penetrating   practioners   espectations   recommendations   Lariboisiere   differentiates   Aponeurotomy   cicumstances   recommendation   experienced   armamentarium