Hi Dr Pess,

I am not American. Here in Canada we in order to see a surgeon we must get a referal from our family doctors which is why I posted to go see your md - is that true of the states or can a person go directly to a hand surgeon?

Anon

Debbie,

generally you have to expect recurrence after surgery, though there are cases where nothing happens for a long time or maybe never again. But surgery might also trigger accelerated Dupuytren elsewhere, that depends on the person, is not predictable, and we not even have sound statistics on the odds.

For Dupuytren NA is a good alternative to surgery, at least worth a try because it is cheaper, easier, and heals faster. NA works well on cords, not as well nodules. Therefore NA doesn't seem to work equally well on Ledderhose, which typically consists of nodules. Surgery for Ledderhose is the standard procedure and sometimes the whole fascia is removed to reduce recurrence. That may or may not work and can have nerve damage as side effect. Alternatives for Ledderhose, though both still quite experimental, might be cryotherapy or Kenalog injections.

For more info you might e.g. look at
- www.dupyutren-online.info (overview on therapies)
- for NA this is a good forum
- specifically for Ledderhose the two Yahoo groups ledderhose_disease and plantarfibromatosis are quite active.

Good luck!
Wolfgang

It is much better to have painful lumps in your hand than a painful bent cock like me. Count your blessings.