I think you are looking past what I said. A person CAN GET a fasciotomy in any major city in the U.S. or Europe. It is basically the same procedure as NA. The cord gets popped, no diseased or susceptible tissue is excised and you go home. Recurrence is a much greater probability than a limited fasciectomy. In the 1800s and after it felt that by just popping the cord was not a satisfactory procedure to slow down the progress of DC. As many have said previously, each person has a different situation so it is a personal decision. If you prefer a fasciotomy or NA it is available, go for it.

Are you faulting the medical industry worldwide or just the U.S.? If you want a fasciotomy, you can have it in about any major city in the world. There is no "trauma" to a fasciotomy if that is what you desire. We have, probably, more (or as many) choices in the U.S. than anywhere in the world for medical assistance. We don't know the particular problem for the person who had several operations so I can't comment on that. For what we know, his condition might not have made him a candidate for NA. If he could have had NA, he also could have had a fasciotomy anywhere.

Gary

Obviously, the person who posted did not know what they were talking about. Hard to respond to a comment like that. I am searching for relevant answers to relevant questions. Trying to find someone with more knowledge of the procedures to discuss this with.

Fasciotomies and fasciectomies are done hundreds of times per week in the U.S. and world by very talented people.
Gary

Spend a few minutes searching the web for 'palmar fasciotomy' and 'palmar fasciectomy' and you'll find that both are well-defined procedures performed regularly by hand surgeons all over the U.S. Read a little further and you'll see that fasciectomy is generally favored because of recurrence statistics, although good data is hard to obtain because patients may or may not decide to return for further treatment. There is extensive literature describing these procedures and some of that is also available via the web.

Among the hundreds of hand surgeons in the U.S. who perform these procedures there are of course differences of opinion. But they're educated, licensed, and subject to peer review and oversight by insurance companies. The suggestion that they're all greedy hacks with little understanding of what they're doing is just ridiculous.

My understanding is that the collagenase treatment is essentially just a non-surgical equivalent of NA or a fasciotomy. Collagenase dissolves the type of collagen making up the DC bands. Enough collagenase is injected into the band to weaken it to the point that it can be snapped mechanically. Whether the recurrence rate is lower with this procedure probably remains to be seen.

I go back to my original queustion which hasn't been answered yet. Why would a person go to Europe to have NA when they can have a comparable procedure (a local fasciotomy) in any major city inthe U.S. or world?
The procedures produce the same results of severing the pre-teninous Dupuytren's cord without removing any diseased tissue. It (local fasciotomy) is done everyday throughout the U.S. and world as a very safe procedure by extremely talented people. One of the first steps of a local fasciotomy is to find the nerve before proceeding. It is very rare that there are severed nerves in this procedure by a micro surgeon.
This procedure is used for older patients who cannot or would be better off not going through an invasive surgery. The fasciectomies are used for younger patients because there is less chance for recurrence than NA or a local fasciotomy. For the person who is afraid of an invasive or is willing to have procedures regularly repeated, then either NA or a fasciotomy might be for them, but why go to Europe?
Gary

Gary – I’ve resisted for some time responding to any of your posts for fear of encouraging more postings. However, I’ll cheerfully answer your question if you’ll promise to go away and give us all a break from your “joy of surgery” diatribes. Why would someone go to France and have NA instead of a fasciotomy?? Essentially, in your MANY postings, you’re questioning why anyone would have NA for any reason instead of taking advantage of fine U.S. trained surgeons.
After consulting 3 hand surgeons locally about my VERY aggressive case of DC, all offered only the standard “chop up your palm with a zigzag incision and remove the cords.” I visited dozens of hand surgeon web sites and they all offer the same procedure. Your assertion that a simple fasciotomy is done all the time in the U.S. is a bunch of crap. Assuming it is available, my health insurance has a $500 deductible; NA cost me $150. The cost of the trip to Europe is irrelevant since I’m going to vacation there with or without this disease. If you have to ask “why go to Europe”, then please don’t go –President Dubya has already set back French-American relations in major ways and your arrival would probably be the final nail in the coffin.
All 3 hand surgeons told me that after surgery it would probably recur in my case and all 3 gave me the brochures explaining that 5% of people who undergo hand surgery never fully recover – that there can be permanent stiffness, numbness or swelling. One chance in 20 offers odds unattractive to me. One of the hand surgeons viewed a videotape of the NA procedure, called me afterward and told me I’d have to be crazy to let him cut on my hand if this procedure was available to me.
I have had NA twice and would cheerfully do it a dozen more times. I vacation in France regularly, so taking half an hour out of my day for a simple procedure to get my fingers straight again is no big deal. You talk about being able to play golf only 2 and a half months after surgery. Well, after NA, you can play golf that afternoon – though why you would go to Paris to golf, I haven’t a clue. My only reason to grip a golf club would be to whomp you in the head, were you nearby. Kristen