Hi; lacking details. this is conjecture; most of us had
a precipitating event (trauma.) Thereupon we noticed
nodules and eventually chords, then contractures.
In my case I believe that I have a genetic predisposition
that involves an over reaction to healing/repair conditions
involving palmar tissue. This condition is referred to as
Dupuytren's Contractures. Associated conditions are Ledderhose (foot/sole,) and Peyronies (male genitalia.)
Bottom line: the trauma "surfaced" a condition already
existent in your body. Absent the predisposition, trauma
would have resolved without nodules, chords, contractures.
NA is the appropriate intervention. Hand surgery is indicated for advanced conditions. The injury or work
conditions did not "cause" the injury. Read up on Radiotherapy, Cryotherapy, etc., then contact an NA Doctor
and resolve the contracture for 2-4 years with a benign
intervention that takes 30 minutes and cost $200-$1,000
depending on the where and when details. Read up on this,
and ask more questions. Then, get NA. I did. Good luck!

Good point Wolfie; I also had a ganglionic cyst totally
unrelated to my DD/DC. Fortunately, I have a competent
Internist who diagnosed the Duputrens. He referred me
to a Plastic Surgeon; equally fortunate, my internet investigations led me to L'hopital Lariboisiere and the
30 years success with NA for DD/DC. Wolfgang is advocating
radiotherapy. I am sure he is sincere; meanwhile, the world's best authority remains: Dr. Jean Luc Lemusiaux in
Paris, France. My surgery was successfully completed by
Dr. Badois in 2003. Dr. Badois is a long time staff member
and protege of Dr. Lermusiaux. I use X-Rays daily in
my occupation. Personally, I would "wait and see" before I
had my nodules/chords irradiated (colateral damage.)

Rock climbing can trigger Dupuytren:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16118302&query_hl=8&itool=pubmed_docsum

@ Stage One:
"Wait and see" with radiotherapy? Wait for what and then see what? Everyone knows how Dupuytrens progresses, if you have the nodules, the affected fingers WILL bent sooner or later (if you don't die early enough).
Radiotherapy can, if you are lucky, HALT the progression of Dups, NOTHING more. Its far away from being a cure.
I wouldnt want to wait until my fingers are bent because the longer you wait, the less effective is RT (see studies).
Collateral Damage?
Please look at Dupuytren-post-op pictures from people with multiple cords removed from their hands, THATS what I call "Collateral Damage"!

Just my 2 cents.

Hi Stage One,

As we all agree it is up to everyone himself to decide what route to go. Without advocating any specific therapy, just three comments on your recents post:

1. you indicate the danger of osteoradionecrosis as result of radiation therapy. According to e.g. eMedicine (http://www.emedicine.com/ent/topic579.htm) "ORN (osteoradionecrosis) is rare in patients who receive less than 60 gray (Gy) radiation therapy. Reports exist of ORN in patients receiving less than 60 Gy and more than 50 Gy, but these cases are extremely rare." - Radiation therapy for Dupuytren typically uses 30 Gray, additionally fractioned into 10 therapies with 3 Gy each and a six weeks recovery period after the first 5 sessions.

2. radiation therapy does not affect later NA or surgery, irrespective of what might be the case in prostate surgery.

3. radiation therapy for Dupuytren is not new, there is about 30 years of experience in Germany.

I already agreed in an earlier post that damage of surrounding tissue is inevitable. That's why only the Dupuytren affected part of the hand (with some fringe) is radiated. The question is whether the damage is too heavy to allow this kind of therapy. Published long-term results don't indicate this (e.g. http://www.springerlink.com/(pbfu3m55xe4naqut5rodta45)/app/home/contribution.asp?referrer=parent&backto=issue,4,8;journal,50,78;linkingpublicationresults,1:103711,1 - scroll down for the English text). Personally I believe that surgery does more damage.

Wolfgang

http://www.chemcases.com/2003version/nuclear/nc-14.htm

The topic is erudite for myself and others; I offer this
link as one of many introductions to the world of Rads, Rems, Grays, and Sieverts. I suggest that everyone educate themselves about radiation therapy (a very valid therapy)
and its side effects. Early stage DD/DC is a nuiscance
at best. I believe that Wolfgang is implying that earlier
intervention (i.e., not waiting for 30 degree contractures)
precludes advancement/progression of DD/DC. Perhaps,that is
true. Time wil tell. My concern is, at what cost, financially, and physically. Does irradiated (30 Grays)
tissue present a less than optimal surgical site for advanced cases? I do not know. I do no that NA will correct
Stage One, Two and many Three cases. Fours are problematic. RT may work very well with minimal sequellae.
Na is gaining acceptance after 30 years of success; perhaps RT is next. Call me cautious; I prefer to "wait and
see" about ionizing energy solutions for relatively benign
conditions. Perhaps I am influneced by the actinic keratosis sites where my youthful sunburn occurred. That
was somatic damage; Just what is the mechanism for RT
and why bother with nodules? I have no vested ineterest.
Does Wolfgang sound much like Sean did? Please keep
us posted. We are all interested in advancements that work
long term. "Cures" will most likely be gene therapy and off
in the future. Either way, have your hands sliced or fried;
you need not suffer the debilitaing effects of DD/DC.
Let us know if you figure out exactly how many Rads. Rems,
Grays, Sieverts, Joules, etc, are involved in individual
cases and what the long term consequences are at a somatic
and molecular level. We are all very interested.