That assertion is 100% wrong in 50% of DC cases. If one undergoes needle aponevrotomy (uh-pon-ev-rot-omee) and follows a special regimen of Colchicine for 3 months, then, if there is improvement, another 9 months of the same protocol eliminates DC in 50% of the cases, per my dr., the great Jean Luc Lermusiaux (the creator of Needle Aponevrotomy).

Keith, you will find many comments in this forum on drinking as potential cause for Dupuytren. It's not likely, there is a loose connection at the most. Much more likely is that the healing process after the surgery triggered your new nodules. While the medical community generally accepts that hand injury can cause Dupuytren, it is less known that surgery, being a major injury, can trigger Dupuytren.

I guess you have experienced enough surgery to look for other therapies. From the UK you might visit France and have NA if your fingers are already bent or, if the new nodules are still in an initial stage, you might visit Germany and have radiation therapy (radiotherapy). After you finally found this forum you might also look at www.dupuytren-online.info for an overview of therapies. This site is even more difficult to find but with URL it's a piece of cake.

In this forum you will find lots and lots of information and you will probably soon know more about Morbus Dupuytren than your doctor. Maybe you can educate him.

Good luck!

Wolfgang

Most hand surgeons wait until the PIP is bent to 45 degrees before surgery. To do so earlier is fairly aggressive because, as you pointed out, it doesn't really effect functionality. And the recovery time and chance of side effects from Open Surgery are to be avoided until absolutely necessary. Most Certified Hand Surgeons put that point at 45 degrees.

No, I wouldn't expect your doc to mention NA or even recommend it. It is very new to the US (only 2 years) and only a handful (5) of CHS are doing it. The rest, assuming they know what it is, still look upon it with a high degree of skepticism. They need undeniable clinical proof that NA is safe and effective. That proof is now abut 9 months away, to be presented at the next convention of American CHS by Dr. Charles Eaton. He was the first to bring the procedure to the US from France where it has been done for over 30 years. I'd guess he now has about 1,300 NA procedure under his belt. I was close to being #1,000 about 6 months ago.

While you may do fine with Open Surgery, you would do well to educate yourself about the newer much less invasive option, NA. I've had them both. For me, no comparison.

See: http://www.handcenter.org/newfile16.htm

Boy tommy, you really know how to put a guy on the spot! For one thing you've left out Door Number Three: Dr. Benhaim who works out of UCLA. He's the latest CHS to throw his skilled hands into the ring, and who Denkler helped train. A short trip down the 405 seems *realy* attractive.

If it were a MCP I'd definitely go local. The PIP is a bugger however, and Eaton did a splendid job on my ring PIP in spite of the fact that waited to just over 30 degrees (don't do that!). The problem is, you are asking me to calculate variables I can't measure. Experience counts for a lot and Eaton is still The Man. At the same time, if Denkler has been to France, one could assume he's on the same track as Eaton. He has made the grade as a CHS, though has focused more on plastic surgery in his particular practice. His before and after shots are just as impressive and he's obviously confident in what he is doing. Six months from now he should be an Ace.

No two bent PIPs are alike. How on earth could I be qualified to look at mine and judge the degree of difficulty? In fact, the best of the best really can't predict their outcome until they pull back on the finger and get that great little snap. If they don't know how well they will do in each case, how can I predict with any certainty when it's time to fly to Paris and seek Out Lermusiaux?

So, since my next NA will probably be a pinkie MCP, I prefer to wiggle out of the question on the grounds that I don't have to think about it. :-) (However when the time comes for the MCP, I've got to consider Benhaim just to get under the skin of my famous (and previous), UCLA surgeon who told me NA was *usless*. Now *that* would be hard to resist.

Denkler should be fine. NA isn't "Rocket Surgery".

tommie,

Remember our Governor in The Terminator. He has a message for you in his German accent:

"Do It Now". (whatever you decide)

I think there are going to be a lot of good doctors who just need to see the concrete stuff Eaton will bring. Hopefully after that we'll all need someplace else to go and say controversial things. :-) There *will* no controversy left here.

No!............I almost forgot. Then we'll need to gently persuade the guys with the right Radiation equipment to make it available without trying to balance the Federal Deficit from the obscene profits.

If Wolfgang is right, then these poor CHS won't even have many NA patients on which to ply their new trick! :-(