Steve,
I was interested in the fact that you are having repeat NA just a year and half after the first procedure. How soon after your first NA did you notice symptoms of new contracture?
Bob

I had NA from Dr. Eaton on 2-11-05. In August I noticed that the PIP joint of the pinky that was treated was starting to bend. This joint was fine when I had NA on the MCP joints of both the pinky and ring fingers in February. It's still under 30 degrees but it's obviously something that will have to be dealt with in the future. Eaton mentions on his website that the PIP joint can do this after treatment.

Dr Eaton did my to fingers two years ago this November; and
while some cords are forming, I do not expect to return until there is significant contraction.
Ar present this is almost none !
Photos and description at http://www.angelfire.com/rings/dupuytrens/

Bob:

Recurrence rates requiring repeat NA or OS are all about the aggressiveness of a particular disease at a particular time. I say particular time because aggressiveness can change in certain people. Also, the range of aggressiveness differs widely. For some, all they will ever need is one procedure, while others may need NA or OS yearly. That being the case, I don't think a measure of "average" would have much relevance even if it could be measured.

In short, Dups is like a box of chocolates. However, I can think of no reason why NA should not be tried first in every case. OS is always available if the result of NA is unacceptable. The jury is still out regarding the actual (assumed) higher rate of recurrence with NA compared to OS. Those of us who have had both procedures are usually on record as willing to play the NA card to the end of the line in an effort to avoid further OS.

I have had two prior surgeries on left pinkie pip joint: most recently in late 2004. Pinkie was bending again to 35 degrees and i was not looking forward to another 3 hour surgery under a general anesthetic. I emailed photos to Dr. Denkler to see it he thought anything could be done and he was cautious but thought he could help.

We made the trip May 2nd. Dr. D thought the biggest problem was scar tissue from prior surgeries which sometimes cracks in the release. He suggested making a small z incision over the pip area and adjusting the skin so it had better chance to stretch. While he was looking in the incision he found more dups tissue hiding underneath the nerve and removed it. So he was glad to have made the incision and find the stuff that would have been hard to reach with the needle. He also used the needle to make releases including one down in my hand that had started after prior surgery. He also said the joint itself was frozen and he fixed that too. He worked on pinkie for over an hour. At the end, I had a pinkie that is nearly straight, (perhaps 10 or 15 degrees) some dissolving stitches and a small splint. Since only a local anesthetic was used, i was able to walk out and go shopping and to lunch. No hospital stay, no general anesthetic. I received a prescription for pain but have only used about two.

Because I live 300 miles away, Dr. Denkler is willing to do follow up by reviewing digital photos I have been emailing, so long as things look ok. This is an enormous convenience. I am doing exercises to keep finger straight.

I was greatly impressed by Dr. Denkler's range of skills as a hand surgeon, plastic and reconstructive surgeon, and NA practitioner and ability to recommend a treatment suitable for my odd case. He told me he has now done 300 NA procedures and in about 5 of those cases, had to do an additional incision as mine required. He is personable as well as professional and I am confident that he will explore any other new techniques that arise.

Because of the prior surgeries, I wasn't sure that I could do anything except have more and bigger surgeries with faster and faster reoccurrence. Now, If I get this in another finger or palm, I know exactly what to do. Dr. Denkler is outstanding and I would highly recommend him to anyone who has this ridiculous disease. I have pictures so email privately if you want to see them.

Diane