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08/07/2013 00:48
pia2some 
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08/07/2013 00:48
pia2some
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Total fasciectomy
I'm just curious ... if your hand has multiple cords and 4 or 5 fingers are affected, is a total fasciectomy ever considered? It seems if there are numerous cords and all fingers are contracting, removing the entire fascia would fix it. Has anyone had this procedure? I know several of you have mentioned having a partial done.
Again, just curious.
~ dawn
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08/07/2013 02:01
Rocket88 
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08/07/2013 02:01
Rocket88
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Re: Total fasciectomy
I have heard that this is very painful.
Since I have it on both hands and both feet, this is a very troubling situation for me. Obviously, you must feel the same.
Today was very hard for me physically and emotionally. I never knew about these diseases until I got them and it poses one heck of a problem for sure.
I am not sure if I would agree to a total fasciectomy though.
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08/07/2013 14:43
callie
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08/07/2013 14:43
callie
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Re: Total fasciectomy
I had a fasciectomy for one finger. The incision went from the base of my palm to the top joint of my little finger. There was very little pain (I didn't use any pain pills). I asked the surgeon about the little pain and he said that he had heard so many patients say that.
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08/07/2013 19:03
moondanc
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08/07/2013 19:03
moondanc
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Re: Total fasciectomy
pia2some:
I'm just curious ... if your hand has multiple cords and 4 or 5 fingers are affected, is a total fasciectomy ever considered? It seems if there are numerous cords and all fingers are contracting, removing the entire fascia would fix it. Has anyone had this procedure? I know several of you have mentioned having a partial done.
Again, just curious.
~ dawn
The first time I heard this surgery described was "it's just like boning a chicken." That was enough to stop me right there. Total fasciectomi involves having zig zag cuts the length of each finger over the affected joints (and I've yet to find out what they do about cords on the sides of the fingers as I have) and several rows of zig zag cuts all over the affected palm.
Unlike boning a chicken, there's a high probability of the need for skin grafts. Given all of this, I'm going to keep on the NA path as long as I possibly can. Also, I've seen recurrence rates, even with total fasciectomy, quoted at over 50%.
Check out youtube, I'm sure you will be able to find this wonderful (shudder) procedure there, in all its bloody gore.
Diane
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08/07/2013 19:08
moondanc
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08/07/2013 19:08
moondanc
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Re: Total fasciectomy
callie:
I had a fasciectomy for one finger. The incision went from the base of my palm to the top joint of my little finger. There was very little pain (I didn't use any pain pills). I asked the surgeon about the little pain and he said that he had heard so many patients say that.
Multiply that by five fingers, the web between the thumb and index finger, and consider the palm may have five or more incisions, I'd suspect there would be considerably more pain especially during the rehab process with scar tissue healing and movement. I would also imagine the size and depth of the cords and nodules to be removed would make a lot of difference from person to person in terms of pain and healing.
Diane
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08/08/2013 00:34
callie
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08/08/2013 00:34
callie
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Re: Total fasciectomy
I can't imagine a procedure as you describe. Is there such a thing for one surgical event? It sure wouldn't be very common. I would doubt anyone would ever try that for NA, nor Xiaflex either.
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08/08/2013 01:02
pia2some
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08/08/2013 01:02
pia2some
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Re: Total fasciectomy
I was just curious about the subject, that's all. I have several older cousins who have had the zigzag surgery and had 3 incisions going from palm up through the fingers. Those surgeries were done probably about 10 years ago.
I have so many cords and nodules and the only finger NOT affected is the index finger on my left hand. Both thumbs now have cords and the web between the index and thumbs have developed nodules and puckering. I have huge nodules on each PIP joint on my right hand. Those hurt! I cannot bend those fingers because the nodules are so large. It's all progressing so fast and my hands are beginning to lose function. In September, I will have an appointment for a second opinion with another hand specialist. Until then ...
~ dawn
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08/09/2013 17:35
moondanc
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08/09/2013 17:35
moondanc
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Re: Total fasciectomy
callie:
I can't imagine a procedure as you describe. Is there such a thing for one surgical event? It sure wouldn't be very common. I would doubt anyone would ever try that for NA, nor Xiaflex either.
First of all, as far as I know with Xiaflex, FDA has only approved one vial per day which *generally* is only sufficient for one cord/ three injections to soften a cord enough to break. I know some docs are using it "off-label" and using more. I know FDA trials are underway for two vials... or more, not sure. Maybe I'm behind the times?
With OHS, what do you think would happen with all four fingers and thumb needing release-- do you think two fingers only?, two fingers and a thumb? the palm and two fingers? recover for six months and come back for another total?
http://wheelessonline.com/ortho/surgical...ens_contracture
Diane
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08/11/2013 00:57
pia2some
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08/11/2013 00:57
pia2some
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Re: Total fasciectomy
That's what I'm wondering, Diane. If your hand is full of cords and nodules and every digit is affected, what's the best approach. Wouldn't be easier to do surgery on everything at once? Yeah, the recovery would be longer and more painful, but it'd be better than doing it a little at a time.
~ dawn
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