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How fast will the disease progress?
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07/20/04 02:36
John

not registered

07/20/04 02:36
John

not registered

NA

Just looking for some valid information instead of opinions. Perhaps there isn't any information to support the assumption. I just ask because it has been 3 1/2 years since my successful surgery and haven't decided what to do yet for my other hand.

07/20/04 02:47
steve 
07/20/04 02:47
steve 
research

if you want information, go to pubmed.com and search on dupuytren...then head to the nearest med school library. There's a wealth out there, one paper by a Dr. Boyer even goes through the complications with surgery. Others compare results of different styles of surgery.

07/20/04 02:56
John

not registered

07/20/04 02:56
John

not registered

NA

Thanks Steve, I'll go to pubmed. If you find something I can't find could you put it on this forum.

07/20/04 02:15
John

not registered

07/20/04 02:15
John

not registered

NA

Steve, thanks for the info. Here is the second one I went to on surgery.

The surgical treatment of Dupuytren's contracture: a synthesis of techniques.

Skoff HD.

Department of Orthopedic and Plastic Surgery, Harvard Medical School, Brookline, Mass. 02446, USA. hskoff@aol.com

Dupuytren's disease is an affliction of the palmar fascia. Selective fasciectomy is recommended once contracture has occurred. Alternatives for wound closure include tissue rearrangement, the open palm technique, and full-thickness skin grafting. In this prospective study, a new "synthesis" technique was used to treat a cohort of patients with advanced Dupuytren's disease. The results were then compared with those of a second cohort of patients who underwent the open palm technique. Thirty consecutive patients were selected. Ten patients (nine men and one woman; average age, 67 years) underwent the open palm technique, and 20 patients (18 men and two women; average age, 70 years) underwent the synthesis method. Follow-up was 3.5 years for the open palm group and 2.7 years for the synthesis group. All patients in both groups improved with respect to motion, function, appearance, and satisfaction. Objectively, for the open palm technique, metacarpophalangeal joint contracture decreased from 50 degrees to 0 degrees, and proximal interphalangeal joint contracture decreased from 40 degrees to 6 degrees. Using the synthesis method, metacarpophalangeal joint contracture decreased from 57 degrees to 0 degrees, and proximal interphalangeal joint contracture decreased from 58 degrees to 10 degrees. The Disabilities of the Arm, Shoulder, and Hand Test scores decreased from 37 to 30 in both groups. There were no significant differences between groups in these parameters. The two significant intergroup differences were healing time (40 days for the open palm technique versus 28 days for the synthesis method) and recurrence rate (50 percent for open palm versus 0 percent for synthesis). The synthesis technique combines with success the best features of current methods for the surgical treatment of advanced Dupuytren's disease.

Publication Types:
Clinical Trial
Randomized Controlled Trial

07/20/04 02:34
John

not registered

07/20/04 02:34
John

not registered

NA

Steve, Did you read the full paper of Dr. Boyer? I didn't get much from the excerpt. It is interesting, he is from the same school as my daughter, Washington Univ. in St. Louis.

07/20/04 02:56
Randy H.

not registered

07/20/04 02:56
Randy H.

not registered

Surgery versus N.A.

".....these therapies (including NA) have not proven to be clinically useful." Not Proven by exactly who and under what conditions?

Gee......good think Eaton doesn't read this site. He might find the article from which the above was quoted and decide to stop performing NA. I mean, this is Authoritative and all, isn't it. It **can't** be just plain Wrong!:-)

07/21/04 02:05
Stage One

not registered

07/21/04 02:05
Stage One

not registered

Surgery versus N.A.

I have a son named Sean; that is Gaelic for John.
If my son wanted a little anonymity, he might use John.
Perhaps this John is not the omnipresent Sean (not my son.)
Antway, I have had NA after a board qualified hand surgeon
suggested that Collagenase therapy would be indicated
when (and if) available. The Lariboisiere site provided
information suffient for me to travel to Paris and have
a 20 minute procedure that released my 30-35 degree contracture or the "little finger." Collagenase is still in trial.

This web site can provide testimony and information. It
cannot diagnose. Some of us (me included) will suggest that
one consider NA before "open-hand surgery" no matter what
the insurance, travel, language factors are.

The "other" web site was closed because of hackers. This
site has "newbies" that would really benefit from the
prior posts; but, naturally, prefer "answers." Surprise!
life is not simple; however, NA is . If you are in doubt,
start with an NA practioner. For me that was in France.
There are others. Do not submit to open hand surgery
without an NA consult with a practioner from the "list"
on Walt's site. Dr. Bourland might (might)be an exception
for an NA consult only, i.e.; he is not on the list, but is referenced by Dr. Eaton.

Anxiety prevails! Knowledge is power; do the work. Take pictures of your hands and e-mail/snail mail them to an
NA provider. My treatment cost 200 Euros and a weeks
vacation in Paris. Air fare was about 300.00 USD. Hotel
was another 500.00 USD. Total expenses for my wife/me
were about 2500.00 USD for a vacation that included returning my hand to normal. For the same price you can go
to Disneyworld in Orlando, or, perhaps, Mudd Island in Tennesse. Do something. Your insurance is not a major factor. No company wants to pay for the treatment.
Percutaneous fasciotomy is as close as one gets to a payable
procedure. Good luck!

07/21/04 02:49
Steve

not registered

07/21/04 02:49
Steve

not registered

articles...

I did read the Boyer paper...it does point out all the risks of tradititional surgery very well. The abtract on NA basically says that recurrance is high but if you can live with that, the procedure is fine. Doctors are trying to find a longer term solution than minor surgery every couple years which NA will entail. That is why the Stony Brook authors said it was not clinically sound - they don't disagree it works if you read it but that the recurrance rate is high - they are also the researchers leading the Collagenase study which while similar to NA appears to have much longer lasting effects since the cord is dissolved, thus more of an appropriate clinical solution. Don't get me wrong folks, I had NA, but for real medical research Pubmed.com will present you the facts from peer reviewed doctors - and there are even papers in their that favor NA.

07/21/04 02:00
tOm

not registered

07/21/04 02:00
tOm

not registered

NA

Does it seem to others that the poster Gary/Sean has now adopted the name John?

Gary/Sean/John you're fighting to fight a losing battle.

07/21/04 02:01
tOM

not registered

07/21/04 02:01
tOM

not registered

NA

Should have been 'continuing to fight a losing battle'.

One could, I suppose admire your tenacity, but I suspect it's more ignorance and hard headedness than rationality.

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Collagenase   information   degrees   interphalangeal   patients   recurrence   procedure   disease   contraction   contracture   technique   individualistic   surgery   synthesis   decreased   full-thickness   recurrance   metacarpophalangeal   Dupuytren   progression