Almost 3 years ago I had surgery on my right hand to relieve contracture in two fingers that had progressed very fast and had reached almost 90 degrees. I was, and remain impressed with how well the surgery went. The followup care was good and I cannot praise the staff enough.

I have read many threads in the forum and I am always amazed at the number of postings that describe uncaring or uniformed doctors and medical staff. I think many of these post are from people who would complain about anything or may be inclined to think that they more than others. I was amazed at well informed my doctors were on Dupuyten's and how knowledgable they were about the treatment options. The other recurring theme in many messages and that doctors only understand surgery. Well, I don't think that is true.

As for my case: the disease advanced very quickly and while I was a candidate for less invasive treatment, I was advised to have the open surgery and after three years my fingers remain straight, I have nearly all the flexibility I had before. Not 100% to be sure, but close. The only reminder is the scar, which does not bother me.

This is a simple thing to say, but if you are a candidate for surgery, be sure to check out your doctor and just as shopping for something, get some references. There are lots of good doctors and medical technicians out there to help you. No-one rushed me into this operation and I was actually surprised at how long I was advised to wait. But, once I had the operation it went well. I was in and out in less than 6 hours and while my hand was bandaged up for 10 days I quickly regained use of my hand. Most surprising was not that I experienced very little pain.

Fortunately, I had not seen any recurrance and so far so good with my other hand. If you are a candidate for surgery, I can attest that it works. I would be very interested in hearing how others have fared after surgery.

Regards,

Jim

Jim,

I welcome your post because, at least from time to time, an advocat for surgery is good! This forum is to a large extent dedicated to NA and does a marvelous job in establishing NA in the US and world wide. But there are also many people, like you, who had surgery and are satisfied. It is sure worth while and fair to mention this from time to time.

My own experience is similar to yours: I had surgery on my left hand about three years ago. Since then I have no recurrence, my finger is still straight and 95% percent functionally (occasionally I drop a fork and that coordinational problem accounts for the 5 %). My surgery was straight from PIP to MCP and then zig-zag through most of the palm. The scar is very minor. I believe I had an excellent surgeon and I also believe you better have a good one (I saw several bad results, fortunately not on my own hands).

Having said all this I personally still would be somewhat reluctant to recommend surgery. That has several reasons: different to you my hand was painful after surgery and it took about six months to recover (but is an example to not give up hope). After three years it is still not as it used to be prior to surgery. I don't suffer from it but I feel some blockage when making a fist (though I always succeed). My worst side effect probably was that I had just a single cord that was operated on and immediately, i.e. within just four weeks, Dupuytren extended to six other areas and there it grew rapidly (someone wrote in this forum "it came back with vengeance", I can relate to that). I had that rat pack radiated, some vanished, the rest grows slower.

In a more generalized view I think that surgery has - on an average - considerably more undesirable side effects than NA. In the forthcoming ASSH conference statistics on NA will be presented and Keith Denkler will present an extensive overview of surgery data as well. The higher percentage of side effects of sugery by no means excludes it as a valid therapy. About 80 percent of the people after surgery have no side effects and are satisfied which is pretty good (and you are obviously one of them). Surgery can help in progressed stages where radiotherapy or even NA can't help anymore.

I think it is not in our interest to line up therapies against each other. We should understand their values and drawbacks and then make the best choice, in cooperation with our MD. But we should have a fair view of all options and your post helped in that respect (at least hat's my opinion).

Besides that it is always good to hear a story that ends well!

Wolfgang

Its good to see more discussion comparing OS and NA. I had two traditional surgeries performed in different parts of the country. Both surgeons were board certified hand surgeons and both did excellent work and were kind gentlemen and the entire experience was with little pain, good immediate results and excellent follow up. I can't complain about any of it. I would see either surgeon again and recommend them under the right circumstances. One of them did a carpal tunnel release on both my husbands hands with perfect results. The second surgery was a lengthy procedure with two surgeons and every single scrap of dups tissue removed and somehow I thought that this thorough procedure would give me a long term fix.

But the PIP bend started back within a year though the distal joint has stayed where it was. For those of us for whom surgery seems to make this condition worse, having OS as the first treatment is probably not the best choice. But you don't know this until after the fact. And since surgeon # 2 told me that eventual amputation might be required, I decided to try NA when the bend came back. I have learned alot about this disease since it started in 1998, the most important being that i have to be proactive in keeping informed on the disease and treatments and getting treatment before the contracture gets too bad.

So my thoughts are similar to Wolfgang's. I would tell anyone to at least consult an NA practitioner before proceeding with OS. I need to use this hand for about 30 more years and it just seems that if i needed an OS every two years, pinkie would not last as long as i need it. But I can envision having NA all those times. Or perhaps collagenase or radiotherapy.

I am so glad that the ASSH presentation is going to cover all the new options and can't wait to hear the follow up.

It is encouraging to see some messages that address surgery where people can tell of their experiences. I had surgery a couple of years ago and it was OK. I don't understand why I got this disease and can only guess it is due to family history, but I had the operation and it worked.

My recovery was a little longer than I would have liked as I had some swelling that lasted about three weeks before it subsided. But after a couple of weeks, I was back to my normal routine. My fingers remain straight and I would recommend surgery. My surgeon was just great. A real gentleman.

Hello all,

I had surgery about 1 and 1/2 years ago and would like to say that I would not hesitate about doing it again. I am in my early 50's and watched the disease advance over about six or seven years.
I had not much experience with any kind of surgery before(knock on wood), but it went just great. Recovery was effectively over in about a month and you would never know I ever had surgery. Even the surgical scar is hard to notice. The only thing I did not like was waiting to get the stiches out. They were uncomfortable.
I don't what's best for others, but I wanted to let people know about my experience.