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Advice please
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10/31/18 11:27
allanbconway 
10/31/18 11:27
allanbconway 
Advice please

I would welcome the opinion of the forum. I had radiation treatment on both hands about 5 years ago. Seems to have worked except on my right hand small finger. I have had two rounds of NA over the last 3 years, but each time after about 6-9 months the little finger goes back to a 90 degree bend. It doesn't hurt, nor does it inhibit me from playing tennis, lifting weights and general gym work. I have seen two surgeons, both suggest that surgery is the way to go.Apparently, NA does have an 80% recurrence rate. Surgery would be 5%-20% recurrence rate. I need to decide whether to have the surgery. It would mean 2 weeks not driving and up to 6 weeks for full recovery. Only reason to do it now is that the longer I wait the less the likely success of fully straightening the finger. What would you do?

10/31/18 12:14
wach 

Administrator

10/31/18 12:14
wach 

Administrator

Re: Advice please

Hi allanbconway,

my 5 cents:

1. After NA you can postpone recurrence by wearing a night splint. In favourable cases a dynamic splint, worn for a few hours per day, can even reduce contracture https://www.dupuytren-online.info/dupuyt...-splinting.html .

2. After surgery "2 weeks not driving and up to 6 weeks for full recovery" sounds VERY optimistic to me. In my case I couldn't make a fist after 4 weeks and it took 6 months to full recovery, which is longer than typical. I would expect at least 3 months until full recovery.

Wolfgang

10/31/18 13:12
spanishbuddha 

Administrator

10/31/18 13:12
spanishbuddha 

Administrator

Re: Advice please

I would look into the possibility of RT for that finger, after another NA. If RT helped before, and only you can judge, then it might help again. Your radiologist would advise about the additional dose, half or full. If this is ruled out, by yourself or radiologist, then perhaps surgery.

11/01/18 03:09
Cherrise 
11/01/18 03:09
Cherrise 
Re: Advice please

Hello. It’s always a difficult decision for treatment for DC . Have you considered xiaflex injections ?
Tried surgery-failed, NA-na, and xiaflex injection finally worked. I wear a Fixxglove every night recommended by the physician. It’s been 7 yrs since xiaflex injection and my fingers are still good.
Good luck & whatever you decide I wish you much success.

11/01/18 09:06
allanbconway 
11/01/18 09:06
allanbconway 
Re: Advice please

Thanks. Both surgeons ( who can also provide NA and Xiaflex) said that they didn’t think another NA or Xiaflex would work in my case. Both emphasised high recurrence rates and dismissed any benefit of using a splint post procedure. I wonder whether going to Paris for another NA and using a splint would be better? That would be third NA and may increase risk of nerve damage?

11/01/18 13:34
spanishbuddha 

Administrator

11/01/18 13:34
spanishbuddha 

Administrator

Re: Advice please

The Paris doctors are very experienced. Maybe relate your story with some pics via email and see whether they think a further NA is possible. They may say yes then change their mind in person, so plan it as a pleasure visit either way. If surgery is the only option I would check references and experience of any surgeon. Ask for that directly, but also ask on forums, FB, etc. RT may still be possible after surgery if there is a hint of recurrence, but you would need to recover as much as possible first.

11/01/18 19:41
Stefan_K. 
11/01/18 19:41
Stefan_K. 

Re: Advice please

Am revising my reply after the Original Post has now been delivered to my inbox eight hours delayed:

Since NA procedures have apparently been successful in straightening your finger before, if I was you I would have it done one more time and then wear a night splint, possibly with radiotherapy if you haven't reached the maximum dose yet, as others have suggested before. Has been working for me for more than three years.

Stef

[56, Dupuytren diagnosis 2006, RH contracture and PNF/NA 2014, radiotherapy RH 2015, LH 2017 & 2018, night splint glove RH since 2015]

Edited 11/01/18 21:15

11/01/18 22:24
Seph 
11/01/18 22:24
Seph 

Re: Advice please

allanbconway; There is no limit to the number of times you can have NA so why not just keep getting it done every 12-18 months.

My Paris doctor cannot straighten one of my little fingers because it had surgery and the other because I left it too long but she can stop the later getting worse. I have now had NA done 8-9 times in the past 12 years (Twice in 2007) and I will be back in Paris for another round next June.

With NA there is no limit to the number of times the procedure can be done, it takes 15 minutes and there is no recovery time. With surgery there is a limit to the number of times it can be done, there is surgery risk, there is recovery time, etc etc. Seems like a no brainer to me.

11/03/18 10:17
allanbconway 
11/03/18 10:17
allanbconway 
Re: Advice please

Seph, thanks. Could you let me have the name of the Paris doctor you used?
Thanks everyone for your replies. I will postpone surgery and have another go at NA.

11/03/18 10:25
allanbconway 
11/03/18 10:25
allanbconway 
Re: Advice please

p.s. does anyone else have recommendations for which doctor to use in Paris? The list is extensive and difficult to know who to go to. thanks

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radiotherapy   backside--that   recommendation   surgery--ultimately   fingers   finger--looking   contracture   surgery-failed   straightening   writing--approximately   recurrence   dupuytren-online   mariepascalemanetchopin   xiaflex   surgery   Dupuytren’s   treatment   recommendations   experience   recovery