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Dupuytrens
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Teemu

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Teemu

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Timing of operation

In a wide study by J.P. Moermans: http://www.ccmbel.org/Chap12.html ( 1977 )is said i.e. "Metacarpophalangeal joint contracture can almost always be corrected, but because PIP joint contracture is so difficult to correct, it has been the common view that the patient should be advised to have an operation as soon as the proximal joint begins to flex. We should modify this view in the light of what we have seen about the role of the pre-operative contracture on the outcome: the results are usually bad under 30 degree, suddenly improve to be perfect between 30- 40 and then worsen again above this value.....It would seem best to wait until 30- 40 degree of contracture is present." ( End )

The problem is, that we all have to decide -what?/when?- from our own personal point of view. Statistics does not help much in this. Studies and discussions -like this forum-serve as a good help, anyway.

Jerry

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Jerry

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Progression

From my own personal prospective: If there is extreme puffiness between the PIP & MP joints, then surgery or APO may be too late. I have had both procedures fail due to this dense and hard amount of scar tissue.

In my case the puffed area was caused by trauma caused by a crunching handshake. I had D/C for almost 45 years and thousands of handshakes, but never experienced the pain associated with this encounter. In a short time my finger puffed and curling commenced in #s 4 & 5. APO was performed on that hand without results, while my other hand was returned to an almost perfect state.

Images of my hands are available for viewing at the following sites:

LEFT: http://www.printroom.com/ViewAlbum.asp?userid=Vitey&album_id=31656&image_id=
RIGHT: http://www.printroom.com/ViewAlbum.asp?userid=Vitey&album_id=84959&image_id=

PLEASE also check the survey site at: http://www.stcatz.org/dupuytren.htm
In the few days that it has been operational it is already providing interesting information.

Jan

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Jan

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thesis dr moermans

Uh.....what am I not doing right? Cannot get to these pages.

Eddie 

Eddie 
thesis dr moermans

Just wanted to mention that thesis if from 1997, not 1977

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