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NA success rate
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04/16/2008 12:33
Dyingbreed45 
04/16/2008 12:33
Dyingbreed45 

NA success rate

What is the success rate of NA? How long before DC starts to come back? I am sure that it differs for each individual but what are the statistics? From what I have read here it seems to be all pro. What are the cons?

Got Dups the hard way,

Dyingbreed45

04/16/2008 14:18
Wolfgang

not registered

04/16/2008 14:18
Wolfgang

not registered

Re: NA success rate

Success rates of NA are very high (like for surgery) if you define them as "less extension deficit" or "finger straight". The average time until recurrence is more difficult to measure because people usually don't report back and just looking at those who get treated a 2nd time would skew the measurement. Anyway, some people report new contracture already after 1 year or less. More typical might be 3 years. The good news is that you can do something to avoid new contracture by wearing a night splint. That potentially might extend the period for much langer. But again, there are no statistics.

Higher recurrenc eis most frequently mentioned as a con for NA, other ones are on http://www.dupuytren-online.info/NA_side_effects.html .

Wolfgang

04/16/2008 18:59
Randy_H 
04/16/2008 18:59
Randy_H 

Re: NA success rate

For additional in-depth reading on Open Surgery and NA see Dr. Eaton's site. His Pub Med references go on for days. You will learn quite a lot. http://www.handcenter.org/newfile16.htm

Yes, in almost all regards NA is superior to Open Surgery except for one significant issue. Recurrence is more of a problem, though there are no reliable statistics on that as yet. That will require a long team study of >5 years which will cost money. Eaton is expected to offer what clinical data he has once enough of his patients reach that time period. I am one of them and getting close.

I think only truly scientific way to study recurrence rate differences would be to randomly assign a significant population of subjects to either an OS or NA group and then track them for five to ten years. Who would benefit financially from such an expensive study? I can't think of anyone so I doubt it will be funded.

What probably will be studies is Collegenase once is passes FDA. It too is subject to higher recurrence rates because it does not remove Dups tissue, just breaks it to release the finger(s). I would imagine those holding the patient would want to show that recurrance is at an acceptable level.

Right now what *really* counts is how well any particular individual does with NA. The idea is to try NA first and see if your recurrence is acceptable for you in particular. If not, there are plenty of CHS eager to take the next step and perform OS. The *real* question we all need to ask is what is the downside of trying NA *first*, leaving OS as a fall back position. I have yet to hear a convincing argument as to what the downside might be. I will have NA (or Collegenase) until it not longer does the job. One OS has already been more than enough for me. :-)

04/17/2008 13:54
Dyingbreed45 
04/17/2008 13:54
Dyingbreed45 

Re: NA success rate

Okay I see. There is no actual removal of the cords/nodules they are just broke up to allow the fingers to stretch out and the diseased tissue takes on an average 3 years or so to return.
So returning to a job that requires heavy lifting, using tools, also repetitive use of hand/s and so on would not be of much help I would think to help reduce the onset of DC.
Also does the diseased tissue that is broke up by NA is the same DC that returns or do "new" cords and nodules appear?

Got Dups the hard way,

Dyingbreed45

04/17/2008 15:34
Charlie 
04/17/2008 15:34
Charlie 
Re: NA success rate

It has been 4 years since Dr. Eaton straighted out my little finger. It remains straight. I email Dr. Eaton pictures of my hand every 3 months. I do not know how many of his patiences continue to send him post NA pictues.

04/17/2008 17:56
Randy_H 
04/17/2008 17:56
Randy_H 

Re: NA success rate

Dyingbreed,

I'm not sure the kind of things you do with your hands necessarily triggered your Dups or would aggravate it, unless it creates *trauma* to your hands. The majority of people get this disease have no knowledge of any precipitating trauma other than that of "older" age >50. That said, I *am* careful with my hands.

The very first medical intervention was performed by Guillaume Dupuytren (1777-1835), hence the name. He opened a small hole in the hand and cut the cord with a knife. The problem was a high rate of recurrence so eventually surgeons began cutting out all of the underlying "fascia" under the skin to reduce this. Later this radical approach was replace by just removing the diseased fascia. However, this didn't solve the recurrence issue. Nothing has.

NA is a return to Dupuytren's original idea, but now with highly noninvasive needle work. Yes, the reaming cord structures can "reconnect" and keep going. With OS they just start from scratch, therefore a somewhat lover rate of recurrence.

So NA is just a new twist created by a current Frenchmen, going back to the original Frenchman's idea. Yep, nothing new under the Sun, only refined and improved.

From what I've read I'd take a shot at saying that NA's average recurrence rate for all comers is probably 20% to 40% greater than that of the current version of Open Surgery. In other words, while OS helped some, didn't solve the problem that Guillaume Dupuytren discovered. For my money OS is therefore not worth it unless viewed as a the next step when and if NA fails.

04/17/2008 20:48
Dyingbreed45 
04/17/2008 20:48
Dyingbreed45 

Re: NA success rate

Thank you Randy,Wolfgang, Charlie

I have to agree that a less invasive procedure beats an OS because less trauma to the hand is a good thing.
To have a wonderful site like this to gain knowledge is a real benefit for those who know little about DC. Never would I have dreamed up such a disease to take over my hand in a sense.

I have stated before this disease was caused from my hand being crushed at work. Yes trauma did cause me to get DC. Not all cases are from trauma but from just having the genetic factor. I read about another case that a man from repetitive use of his hand and the tool he used being forced into his palm brought DC on in his hand. There may be only so many cases that have been accepted for causing DC. This will be debated for many years because there is little known or accepted cases where trauma was the cause.

What my thoughts are is that since there is more of a genetic factor that DC will be more of a heredity thought disease until further studies are performed.

A physician is the best way to find out what procedure is best since I have scar tissue that is not DC in the area where my hand was crushed correct?

Got Dups the hard way,

Dyingbreed45

04/18/2008 04:32
diane s

not registered

04/18/2008 04:32
diane s

not registered

Re: NA success rate - do our own study

Here's an idea. Can we do our own survey on NA success rates and recurrence on this site? Each person who has had NA could complete a series of questions such as:

date of NA
which digit
degree of contraction pre and post NA
whether there is new Dups in another location
whether there was prior surgery

The survey could be repeated annually and the results posted on this site. I realize this would not be a true scientific study but the data would be of interest to all of us.

FYI, I am at two years after NA with only a degree or two of contraction returned but have a new nodule in palm.

diane s

04/18/2008 13:52
marjorie 
04/18/2008 13:52
marjorie 
Re: NA success rate

Hi Diane,
That sounds like a good idea.
Are you the farmer lady?

04/19/2008 03:05
diane s

not registered

04/19/2008 03:05
diane s

not registered

Re: NA success rate

Nope, I am the retired lawyer now artist

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