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Less Invasive Surgery
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22.10.02 02:05
S. Williams

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22.10.02 02:05
S. Williams

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Less Invasive Surgery

I would love to hear from anyone who has had a "less invasive" type of surgery. Were you satisfied? What were the results? Would you do it again?
I was slated for surgery this Oct. 21, but was saved by a case of the flu. Surgery has been rescheduled for December. Now I'm having second thoughts about "regular surgery," and would love to know more about the Transverse procedure, or any less invasive technique. Am not familiar with any of them.
My Doctor did a "less invasive" procedure at the Lahey Clinic in Massachusetts for a patient who quoted from this forum. Would love to hear from that person, if possible.
Any information would be more than appreciated.
Thank you!!

22.10.02 02:59
Gary Evans

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22.10.02 02:59
Gary Evans

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less invasive surgery

S.Williams,
The less invassive surgery, Segmental Aponeurectomy, can be seen at: http://www.ccmbel.org/These.html

There is a wealth of information at that website.
You could be referring to a Fasciotomy, also. My surgeon uses the Fasciotomy instead of the Fasciotomy (the zig-zag incision), for elderly people. It was his opinion that the procedure was not as good as the Fasciotomy, although he was willing to do either one if needed.
My surgery has been well documented on this forum (90 degrees to 0) and I would do it again. Hand is totally normal at this time. Some don't have as good success.

What is the severity of your progression? Have you considered everything including NA. You could have recurrence with any of the procedures. My surgeon felt that the Fasciotomy was best, but that was his opinion.

Also, you could wait for the possibility of injections being researched by this forum manager.
Good luck, ask questions.
Gary

22.10.02 02:05
Tom 
22.10.02 02:05
Tom 
NA

Also checkout the following webpage:

http://members.rogers.com/dupcon/update.html

Shows results 7 months after NA.

For your own good, check out all options before having very invasive surgery. There are far more horror stores than not from people who were not fortunate enough to have NA.

Regards,

Tom

22.10.02 02:40
Gary Evans

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22.10.02 02:40
Gary Evans

not registered

less invasive surgery

S.Williams,
I misspoke in my previous message. I meant to say my surgeon used the fasciotomy on older patients, but did not consider it as nearly as good as procedure as a fasciectomy for younger people. The recurrence came back faster, from his experience, with the less invasive procedures.
Gary

22.10.02 02:01
Tom 
22.10.02 02:01
Tom 
less invasive surgery

Gary, which less invasive procedures did your surgeon use in addition to fas?

Thanks...

22.10.02 02:41
Gary Evans

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22.10.02 02:41
Gary Evans

not registered

less invasive surgery

My surgeon has used the fasiotomy for older patients:
Fasciotomy

Simple release of the contracted fascia can result in prolonged or permanent release of the contracture as has been demonstrated by the correction of the contracture after trauma (Grace et al., 1984). Historically open and closed wound approaches have been used for fasciotomy (McGrouther 1990d). Open wound release was performed among others by
Dupuytren. Closed fasciotomy was advocated by Sir Astley Cooper (1822) by the subcutaneous division of a band with a
pointed bistoury introduced through a small wound in the skin; a splint was then applied to maintain the finger in a straight position.

As the frequency of recurrence became apparent, simple fasciotomy was progressively given up except by some surgeons if the band is well defined and bow-stringing (Colville 1983, 1990) or for the division of bands proximal to the distal palmar crease (Rowley et al. 1984).
Gonzales (1971, 1985, 1990) has advocated either a fasciotomy or a limited fasciectomy in the digits with interposition of Wolfe grafts. The operation of fasciotomy and graft (McGregor 1985) requires division without dissection of the retracted cords.

His normal procedure is the McCash procedure or limited fasciectomy described by Hueston(1961).
Many other authors moved from radical to limited fasciectomies following the principles stated by Hueston. Further technical refinements were described by Skoog (1967, 1985) who introduced an anatomically precise operation preserving the transverse fibres of the aponeurosis which are not involved by the disease.

Another approach was proposed by McCash (1964) who felt that the impaired vitality of the palmar skin after limited
fasciectomies made through zigzag incisions or straight incisions converted to Z plasties was the source of many problems. Those skin flaps were thus undesirable. Skin grafts impose the immobilization of the hand and he also felt that they should be avoided. His approach was to make incisions in the transverse skin creases and to move the undermined skin bridges so that the skin shortage is transferred to the distal palmar crease incision which remains wide open. Only the diseased fascia has to
be removed. The open wound is dressed at weekly interval. The wounds generally close in 2-5 weeks and since they remain open, there is no possibility for an haematoma to collect. A disadvantage of the open palm technique is that the patients are apprehensive about the open wound. The great merit of the method is its safety. Nevertheless, it only partially solve the problem of the finger contracture.

The procedure he uses depends on the patient. He went into my surgery planning to leave it as an open palm, but changed because of the texture of my skin was to his liking.
Much of the above information can be found in J.P.Moermans thesis.

Gary

22.10.02 02:49
Tom 
22.10.02 02:49
Tom 
less invasive surgery

Gary, I'm having a hard understanding the cut & paste you did. In an earlier email you seemed to say that your surgeon did a variety of techniques, some less invasive than others. That was what my question was in regard to. I'd appreciate if you could answer the question simply and not be obtuse.

What other techniques than a fasciotomy or a derivation thereof does your hand surgeon use? Please no more text book cut & paste.

22.10.02 02:17
Gary Evans

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22.10.02 02:17
Gary Evans

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less invasive surgery

I will try to make it very acute for you.

The least invasive technique that he recommended was to do nothing and live with DC.

Gary

22.10.02 02:16
????

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22.10.02 02:16
????

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Nothing New

What a lot of DOUBLE TALK.........

22.10.02 02:28
TOm

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22.10.02 02:28
TOm

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Nothing New

Thanks for nothing Gary. You've reached a new low for innuendo and double talk. Guess the only technique your surgeon or surgeon buddies can perform is fasiotomy. Perhaps there is a degree of difference depending upon the incision technique, but that is all. Since you cannot make any claim otherwise, seems a logical conclusion.

Maybe you should just create a category called "Garys Life Story & What you Should Do" and leave it at that. I'm sure your hands would welcome the respite from typing the same thing over and over and over and over again.

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bow-stringing   diseased   fasciectomies   Aponeurectomy   ~sq~surgery~sq~   surgeon   fasciectomy   recurrence   understanding   immobilization   information   contracture   progressively   Fasciotomy   interposition   procedure   Invasive   material   technique   Surgery