I have a question I was hoping some of you pros could answer for me.
First a brief explaination of my situation. I started noticing my DC in 1996. I've now got about 6 nodules on my palm; three of them being somewhat large and sometimes painful. I've got one large nodule on my pinky located between the two bottom knuckles. It too is sometimes painful. I had NA last October(2005) and it seemed to shrink the nodules and straighten my finger fairly well. Unfortunetly about 4 months ago it all started returning. The three nodules on my palm and pinky are back to the same size as before the NA. Also, my pinky finger is now bent about half way back to the way it was before NA. I suspect if left untreated it will eventually go all the way back to the way it was before NA.
My question is: In Winter 2005 about 9 months BEFORE my NA treatment, I went to a hand surgeon. He told me to fix my DC would require surgery. He explained the procedure, the after-care and cost. (The cost was considerable.) I'm self employeed and unfortunetly I do not have health insurance. So I asked the doctor that instead of doing full all-out complete surgery would it be possible to just cut out the 4 big nodules. The ones that were sometimes painful and bothered me the most. His reply was "NO" and he didn't really explain very well why this could not be done. Now I know the procedure I suggested would not straingten my finger, but I was hoping it would get rid of the most bothersome nodules. I asked, what about the nodule on my pinky. The one that is the biggest, most painful and the one that bothers me th most. His reply again was, "No this could not be done."
***** Does anybody know why this cannot be done? Why they can't just cut out one or two of the really bothersome nodules? ***** Any help would be greatly appreciated. Thanks so much.
Hi Billy, I am not a "pro" but I could speculate why your MD said "No" (only he would really know why). I could imagine wo reasons:
a) the nodule, specifically if your finger is bent, is usually extending into a cord along that bent finger. Surgery on a finger only makes sense if you remove all deseased tissue on that finger and that could extend far beyond the nodule. I myself had an inconvenient nodule on my left ring finger, or rather in the palm slighltly below the major joint of that finger. To remove the deseased tissue the finger had to be opened nearly up to the tip as well as a major part of the palm. If you don't do that Dupuytren will come back soon, probably a little later than with NA because at least some of the tissue was removed but still it will come back and then, due to scarring, it is much more difficult to repeat surgery.
b) if you have several instances of Dupuytren nodules and cut out only one, then there is a fair chance that the healing process after surgery will get the remaining nodules into much quicker growth. If that happens you are afetr surgery in a worse position than before.
Even with the fats recurrence after your recent NA I personally still believe that you are better off with NA. It can be repated and it is much cheaper. If you decide for surgery then you should really have removed all deseased tissue but from what you describe that sounds like a major operation. Still feasible but make sure that you have a good surgeon.