Hi Dana. I am not a doctor, just another patient with Dupuytren contracture who got his pinky straight with successful NA in 3 minutes at the cost of two metro tickets (less than 4 (four) US$), thanks to my location and the expertise and social security system here in France. Others may have other valuable input especially if you give a more detailed description of any nodules or cords.

My first reaction, unless there was a misunderstanding, would be to go see another doctor if yours actually mentioned medicine and its cost as a reason for not recommending NA, because all needle aponeurotomy takes is a needle with a local anesthetic and a trained and skilled doctor, see http://www.dupuytren-online.info/needle_aponeurotomy.html.

I cannot speak to a "joint jack" as I have not heard of it but from your description I am sceptical about its usefulness for Dupuytrens contracture.

With a little reading on this website and other feedback you will hopefully get here you should be well informed by the time you see your doctor on Monday and able to ask the right questions before getting into any treatment.

When talking about expensive medicine, your doctor may have been thinking about the injection of XIAFLEX enzyme to weaken the cords instead of with the needle used in NA (http://www.dupuytren-online.info/dupuytren_collagenase.html), although I have no idea of its cost as a "medicine". I would be interested in hearing more about his reasons for discounting other treatmens as to expensive because of medicine.

Hi Dana,

Which VA facility are you dealing with? In the past I've had my DD dealt with by our local Kaiser hospital, but I switched over to VA for my health care last year. I haven't asked my doctor about DD expertise yet, but I know I'll have to investigate it in the future - I use the VA in Palo Alto, Ca.

As for the joint jack, when I had my first surgery the surgeon was unable to get my ring finger to straighten out because the PIP joint had become fused. The PT prescribed a contraption that attached to my hand on either side of the PIP joint, using velcro. It had a screw mechanism that was supposed to put pressure on the joint to straighten it out. I had to wear it for an hour at a time, constantly turning the screw every 10 minutes to force the finger straight. It didn't work. I guess once the joint fuses there's not much you can do about it.

I had NA done at Kaiser several years ago on my other hand and it seems to have helped - the finger that was affected can be straightened and used, but I can still see the affected area in the palm - NA apparently doesn't remove the cords, it just breaks them.

Alan Hepburn
San Jose, Ca, USA