Thanks Randy H for your thoughtful points. As a surgeon who has cared for hundreds of patients with Dupuytren's, your thoughts are well said.
This board is an "open" forum and a great place to discuss new ideas to be shared by all.
By the time NA has "caught on" with hand surgeons, newer and better techniuqes may be available. I would love to have collagenase available for my patients, but it is still under study by the FDA and I don't know when I will be able to use it!
Till then, there are multiple techniques that may be used for Dupuytren's. These range from NA to major excisions and skin grafts.
I think NA is a significant advance, yet believe me, it will take years before it becomes popular among hand surgeons or plastic surgeons a group.
Keith

To my knowledge NA does not disolve anything, it only releases the cord. This fact was my surgeons biggest complaint with NA '...the disease is still in there...'. Yes, but my finger is straight so who cares...plus neither surgery nor NA halts the progression of DC so....the disease also remains with surgery. It's true that the doctor can scrape away the lumpiness, but, it does return.....it's only a matter of when.

Hope this clarifies things.

Alan,

Another problem rarely mentioned with NA is the possibility of cutting nerves or arteries. Although rare, it can happen. Not to mention that NA can accelerate dups. But, I've told by a hand surgeon that for some patients (particularly older ones), it may be the better option, although I felt comfortable with surgery. It will approach a year soon and so far, so good.

It's my understanding that at the moment, NA and Surgery are *both* temporary ways of dealing with DC.

I think our best bet for a long term solution lies with Dr. Bing Siang Gan (see thread below with his name). The Collegenase study has been so intermitent and fragile that I don't know if it will ever get done. I hope it does but am not holding my breath.

No name

Michael:

Yes, with NA the needle *can* be used on the palm if that is where a cord can be attacked and snapped. If you'd like to see a DVD, Walt Stagner taped his French procedure and can send you one. See for yourself! I think he charges $5 for his trouble. In fact, seeing this DVD is what helped get Eaton interested in NA.

http://www.wstagner.com

As far as the cord tissue being broken down and reabsorbed, I wish that it were so in all cases. Many testimonies her seem to indicate that's not always the case.

EATON: "<After Snapping,> the cord is softened and digested by the body's normal enzymes, and heals in a lengthened state. The cord is a normal structural layer which has become wider and shorter from the effects of Dupuytren's. It is not a tumor - it does not have to be removed, and when it is returned to it's proper length, it becomes hard to feel - just like it was before Dupuytren's affected it."

Though this sounds like wishful thinking, it probably *is* the case for those with non-aggressive cases. And unfortunately it appears to be the case that the aggressiveness of each of our own diseases has more to do with what can trigger it and reoccurrence rates. A long standing debate on this site has been whether or not surgery itself can trigger more Dups. I personally have a strong belief that *trauma* can trigger growth, so surgery would qualify. And so then too would *NA*. You have to pick your poison here, but personally I'll go with as little trauma as I can get.

I hope I answered your question (though a lot of it was *opinion*, and I have an *admitted* bias)