Dupuytren's Contracture

 

Dupuytren's Contracture is a common problem which develops most frequently in men after age 40. It is usually hereditary occurring in people of European and Western Asian ancestry. It is unusual in Oriental or African-Americans.

This usually starts as a painless nodule in the palm. It can progress to fibrous cords extending into the fingers, most commonly ring and little. These bands can cause contracture of the fingers. It can progress slowly or rapidly. The flexor tendons are not affected.

Needle Aponevrotomy (also known as Needle Aponeurectomy or NA), a minimally invasive treatment, is now available at Central Jersey Hand Surgery.  This treatment was developed by Dr. Lermusiaux at theHôpitalLariboisière in Paris, France and has been performed for over 30 years. Dr. Lermusiaux and his colleagues have published data describing the success and safety of the procedure.

Dr. Pess visited Dr. Lermusiaux in Paris in February 2005 to observe the procedure and was personally instructed in the technique. Dr. Atik was similarly trained in January 2008. The treatment can be performed on one hand at a time, takes ~15-20 minutes and can be done with or without light sedation. There is no incision and no sutures are necessary. A light dressing is applied and the fingers can be moved immediately. Over 3,000 fingers have already been straightened utilizing NA.

NAwas featured in the New York Times and Science Times. Dr. Pess and Dr. Atik are listed as two of the Certified Hand Surgeons in the USA who perform the procedure ( http://www.dupuytren-online.info/NA_list_North_America.html).
 

In May of 2008, Dr. Pess presented his preliminary results of NA at the Nineteenth Annual Richard J Smith, M.D. Resident and Fellows Conference at  Massachusetts General Hospital in Boston, MA.

Click for a Handout of the talk

For more severe cases, surgery may be necessary and a partial palmar fasciectomy is performed. All diseased tissue is meticulously removed and the contractures released. At Central Jersey Hand Surgery, we usually use the open palm technique which we have found decreases postoperative pain and allows quicker recovery. Surgery is performed as same day surgery under regional or general anesthesia. Hand therapy is started within 1 week of surgery.

To schedule NA, please call (732) 542-4477 x206. 

It is recommended that you first email photos of your hand. Shoot photos down on the palm with the palm facing up. A close-up photo of the disease and a side view is also useful.

For a consultation and examination first (not the procedure), call (732) 542-4477 or any of our other two locations.

Revised 7/21/2008
A Gary M. Pess, MD Web Page Production