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Needle Aponevrotomy
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07/22/2010 14:57
ronmcham 
07/22/2010 14:57
ronmcham 
Re: Needle Aponevrotomy

Thanks for the continuing great feed back. I am really still on a learning curve. My original thought was to find a local NA Doctor and get it behind me. Not that easy. I have found NA Doctors in Austin, San Antonio and Houston. However, every On Line search points to "The Hand Center in Jupiter, Fla" I will continue my due deligence and develop a game plan.

07/22/2010 17:18
dave t

not registered

07/22/2010 17:18
dave t

not registered

Re: Needle Aponevrotomy

Everyone has a favorite doc and that's s good. I have heard great things about Eaton in Jupiter FL and Bourland in Memphis, TN. Both have ten years+ experience with NA. I went to Bourland and he's good.


For NA, I'd go to either doc. But be prepared for recurrance. I had NA a year ago, and less than a year later my hand was just as deformed. I just had the first of several xiaflex injections. I actually am very positive about xiaflex, although it is early.

07/22/2010 17:46
ray

not registered

07/22/2010 17:46
ray

not registered

Re: Needle Aponevrotomy

I have had this problem on my left hand for 17 years and three ops involving general anaethesia. The outcome has been very dismal. The small finger which was causing the problem is still set at 50 degrees and the finger next to it which was unaffected is now quite numb along with the small finger. The skin graft site is still raised itchy and red after 2 years and I have a constant pulling sensation in my small finger which never goes away. Not a great result after three ops. Even one of the surgeons suggested amputation of the small finger as a possible solution !

I am so pleased that NA has finally arrived to the shores of the UK. I have two other fingers in the left hand which are contracting so I am quite happy to give NA a go for these contractures. I am well aware that recurrence will be very probable but I think the good thing about NA is that you do not need to endure the risks of general anaesthesia and scar tissue is not a major issue. This means that you could repeat the treatment a number of times with the only risk of nerve damage.

07/22/2010 23:21
bstenman 
07/22/2010 23:21
bstenman 
Re: Needle Aponevrotomy

The charge for both hands with Dr. Denkler in Larkspur, CA was $1100 and his offices are an hour's drive north of the San Francisco airport. You could arrive in the early afternoon, drive up for a late afternoon appointment and fly back home the same day. Lots of discounted fairs flying American Airlines or Southwest.

11/05/2010 18:45
Pat Rucker

not registered

11/05/2010 18:45
Pat Rucker

not registered

Re: Needle Aponevrotomy

I had Neddle Aponeurotomy performed in Dr. Doyles office on Oct. 25th 2010----his first patient. It went very well and the finger is straight. I've had Dr. Doyle do several hand surgeries in the past for Dupuytrens.

Pat Rucker--214-587-5533. pat.rucker@tx.rr.com

11/05/2010 20:43
patandpaula 
11/05/2010 20:43
patandpaula 
Re: Needle Aponevrotomy

Pat, are you speaking of Dr. Michael Doyle in Dallas? I have called his office twice to ask if he does the NA procedure and was told he did not. If it is the same doc, since you know him well, you may want to tell him that his office staff does not know he will do this procedure.

Paula

11/05/2010 20:51
spanishbuddha 

Administrator

11/05/2010 20:51
spanishbuddha 

Administrator

Re: Needle Aponevrotomy

@ray:
I have had this problem on my left hand for 17 years and three ops involving general anaethesia. The outcome has been very dismal. The small finger which was causing the problem is still set at 50 degrees and the finger next to it which was unaffected is now quite numb along with the small finger. The skin graft site is still raised itchy and red after 2 years and I have a constant pulling sensation in my small finger which never goes away. Not a great result after three ops. Even one of the surgeons suggested amputation of the small finger as a possible solution !

I am so pleased that NA has finally arrived to the shores of the UK. I have two other fingers in the left hand which are contracting so I am quite happy to give NA a go for these contractures. I am well aware that recurrence will be very probable but I think the good thing about NA is that you do not need to endure the risks of general anaesthesia and scar tissue is not a major issue. This means that you could repeat the treatment a number of times with the only risk of nerve damage.

Hello ray, I know someone who did have the small finger amputated, in this case instead of a fasciectomy. I know that sounds drastic but the condition was deemed too severe for a successful surgery. I think in this respect the person concerned is happier without the finger now. YMMV

11/09/2010 02:56
mkcliff 
11/09/2010 02:56
mkcliff 
Re: Needle Aponevrotomy

@ray:
I have had this problem on my left hand for 17 years and three ops involving general anethesia. The outcome has been very dismal. The small finger which was causing the problem is still set at 50 degrees and the finger next to it which was unaffected is now quite numb along with the small finger. The skin graft site is still raised itchy and red after 2 years and I have a constant pulling sensation in my small finger which never goes away. Not a great result after three ops. Even one of the surgeons suggested amputation of the small finger as a possible solution !

I am so pleased that NA has finally arrived to the shores of the UK. I have two other fingers in the left hand which are contracting so I am quite happy to give NA a go for these contractures. I am well aware that recurrence will be very probable but I think the good thing about NA is that you do not need to endure the risks of general anaesthesia and scar tissue is not a major issue. This means that you could repeat the treatment a number of times with the only risk of nerve damage.

I just found this website, and am so grateful!! My Duputryn's Contracture , started in my early 40's! I am now 64 years old! It was caused by a trauma, to my right hand, right in the center of my right hand palm. 10 years, after the trauma, my ring finger got to the position that didn't allow me to wear surgical gloves! I work in the health care field and I knew I had to do something! The open hand surgery, that I had, almost 20 years ago, took four hours under a nerve block under the axial (arm pit) area of my right hand, to numb the whole area. The results, as far as straightening out my ring finger, were great, however after 2 weeks into my 6 months of 3x a week, Physical Therapy, I developed, "RSD", Reflex Sympathy Dystrophy, now referred to as Chronic Regional Pain Syndrome, or CRPS! The pain was a terrible burning, that after, many attempts, at a pain clinic, with two different types of pain therapy, did not resolve. I first was given a pill, Gabentin, or Neuontin, at a dosage, that increased, over time to get some relief, to 3 grams a day. Finally, when that didn't work, and I was beyond the recommended dosage of that med, I was put on Vicodin and am had three "Stellate Gangleion injections in my neck with a med to try to shut down the Sympatethic Nervous System! When I had a bad reaction, to that attempt to stop the RSD, I had what is called a "Bier Block", where a tournaquet is applied on the upper arm, and a anethesic drug, Bretyllium, was injected, again to try to interrupt the RSD pain! Now after 20 years, since the surgery, I take Norco, twice a day, just to be able to attempt to control the pain. As I have said, it has been 20 years, since the "open hand procedure". Shortly after that "right hand surgery", I pointed out to my surgeon that my left hand was developing a "nodule" in my left hand. After 10 years, once again, I was unable to put a glove on my left , needed, in my work, and ended up learning about the NA procedure. I went to Larkspur, California,, to Dr. Keith Denkler! He used only needles, and manipulated my "middle finger on my left hand", to very close to normal, after being at 45 degrees. It only took maybe 45 minutes, and my recovery was about three weeks, for the wounds to heal. He used an 18 guage needle, and pulled and tugged, and straightened it out! I am now almost a year and 5 months out from that procedure! I have NOT developed any RSD, (CRPS), from his procedure, even tho, my hand is lumpy and bumpy, it works just fine. HOWEVER, the real reason, that I now am asking for advice, wisdom and help, is the following: Just recently, a month ago, during a therapy session on a patient, I experienced a very painful, "electical shock-like pain shoot through the original ring finger, (the open hand surgery, performed, almost 20 years ago)! It affects, now my daily normal household chores, and makes it almost impossible to continue my work as a Pelvic Therapist! Just went to my primary doc, of 25 years, and he says, not much I can do about it! Has ANYONE experienced this terrible shocking pain, after so many years of the "open hand procedure"? And if so, what have you done, and have you any advice for me.

I know that this post has been so very "long winded", but I am at the point where I may have to leave a career of almost 9 years, that is a very important part of my life. If any of you have any advice, I would be so happy to hear any thoughts, of any kind, and also your own personal stories!

Thank you very much, for reading this post, (those of you who made it through to the end)! I am forever in your debt!


With my thoughts and best heartfelt love to those of you who understand the pain this, (mostly unknown condition) is!

Kathy Cliff

11/10/2010 02:59
flojo 
11/10/2010 02:59
flojo 
Re: Needle Aponevrotomy

So sorry about your problems. You have come to the right place to get input from others who may have had the same syndrome. I have seen it mentioned on the Forum, but it is not very common.
Good luck and keep coming back to ask more questions or just for ideas for just sympathy from others who understand.

11/10/2010 17:23
mkcliff 
11/10/2010 17:23
mkcliff 
Re: Needle Aponevrotomy

Thanks for the welcome! It is sure nice to know that I am not alone! If anyone has had any recurrent nerve pain after 10 years, post 'Open Hand Surgery", for Duputyn's I would sure love to know what you did for it. Thanks, Kathy

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