The Hand & Wrist Center
3918 Long Beach Boulevard, Suite 100
Long Beach, CA 90807
Phone: (562) 424-9000
Monday - Friday: 8:30 a.m.–5 p.m.
Dupuytren's Contracture Treatment Options and Risks
Until recent introduction of Needle Aponeurotomy, patients with Dupuytren’s Contracture, also known as Dupuytren’s Disease, did not have other viable options outside of the traditional surgical approach of Fasciotomy (Fasciectomy), which involves dividing or completely removing abnormal Dupuytren’s hand nodules and cords. These traditional procedures usually involve extensive surgical incisions, which often produce extensive scar tissue, swelling, and stiffness. After traditional, open surgery for Dupuytren’s Contracture, most patients require extensive therapy (bandages, wound care, splinting, range-of-motion exercises, etc.) to minimize complications and optimize results. With the Needle Aponeurotomy procedure, scarring and stiffness are significantly decreased, affording patients the opportunity for a shorter, quicker recovery. Below, is a “Comparison” chart, developed by Dr. Eaton, which illustrates the differences between procedure expectations.
|Setting||Office – One Day||Outpatient Surgery|
|2 to 7 days||2 to 3 months|
|4 to 7 days||4 to 6 months|
|Fees||Physician||Physician, facility and anesthesiology|
|Therapy||Uncommon||Common, minimum 3 days per week, for 4 to 12 weeks|
|Splinting||For PIP or multiple releases, nightly for 3 months||For most releases, nightly for 3 months|
|Repeatability||Any time||Patient must wait for at least 3 months; may be difficult|
(Source: © 2007 Charles Eaton, M.D., www.handcenter.org)
Click here to view The Eaton Diagram: Patient Education Poster©.
What Are the Risks for Needle Aponeurotomy?
As with all procedures, there are potential, but minimal and low-occurrence risks with Needle Aponeurotomy. The most common risks associated with this procedure are as follows:
- Open wound resulting from in-office contracture release
- Bleeding at contracture release site
- Infection of open wound
- Nerve irritation and/or injury
- Tendon irritation and/or injury
- Superficial discomfort during and after the procedure
- Scarring at contracture release site
- Local hypo-pigmentation of skin at injection site (following local anesthesia injection)
- Recurrence of contracture
- No relief from procedure attempt
As stated by Dr. Eaton, it is important to recognize that the primary focus of Needle Aponeurotomy is to help patients regain a reasonable amount of functionality without extensive surgery or rehabilitation. It is important to recognizing that Needle Aponeurotomy does not remove the abnormal Dupuytren’s tissue (as in traditional, open surgical excision); therefore, the rate of tight cord and contracture recurrence following Needle Aponeurotomy greater than with traditional open techniques. However, because minimal (if any) scar tissue forms after Needle Aponeurotomy, if there is recurrence, repeat Needle Aponeurotomy (or surgery) can then be performed without significant increased difficulties.
In addition, it is important to factor in that this procedure does not address any other underlying conditions, such as Arthritis, Tendinitis, or nerve-compression syndromes.Back to Top