Dupuytren's Contracture is a common problem that develops most frequently after age 40. It is more common in men than women, though both can be affected. It is usually hereditary occurring in people of European and Western Asian ancestry. It is unusual in Oriental or African-Americans. Dupuytren's 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 Aponeurotomy (also known as NA), a minimally invasive treatment, has been available at our Northeast Center for Dupuytren's Contracture since 2005. This treatment was developed by Dr. Lermusiaux at the Hôpital Lariboisière 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 and Dr. Atik have both visited Dr. Lermusiaux in Paris and were personally instructed in the technique. 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 safely utilizing NA.

NA was 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.

Click here for the listings.

In May of 2008, Dr. Gary 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.

In September of 2008, at the Sixty-Third Annual Meeting of the American Society for Surgery of the Hand in Chicago, IL, Dr. Gary Pess presented his prospective study: Needle Aponeurotomy for the Treatment of Dupuytren's Contracture. This was the first presentation of American data showing the clear benefit of NA. All patients had a follow-up of at least 2.5 years.

Click for a Handout of the talk.