FIXING A CRIPPLING HAND DISORDER
Imagine not being able to straighten your fingers? That's what it's like for about seven million Americans who suffer from Dupuytren's contracture. Until now, a risky surgery was the only fix. But there's now an easier solution.
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Mike Smith
"It started physically interfering with things that I did, and I also knew it would get worse."
Today, Mike Smith can use his hands even though he has Dupuytren's contracture -- a condition that if untreated, prevents his fingers from straightening.
Mike Smith
Has Dupuytren's contracture
"If I would go to the opera or the symphony, I couldn't clap."
Dupuytren's causes the fibrous tissue in the palm of the hand to thicken and tighten -- forcing fingers to contract.
Mike Smith
"It got to the point where my finger was probably like that."
Doctors recommended surgery, but it can take a long time to recover.
Keith Denkler, MD
"What they do is they start to cut here, and they zig-zag down and filet open the finger, core it out and re-stitch the skin."
Instead of surgery, Mike opted for an alternative treatement called Needle Aponeurotomy, or NA.
Instead of a scalpel, Doctor Keith Denkler inserts hypodermic needles to cut the contracted tissue and straighten the patient's fingers. The hand is numbed with local anesthetic.
Keith Denkler, MD
Plastic Surgeon
University of California, San Francisco
San Francisco, CA
"The advantage of this procedure over traditional surgery is a very rapid recovery."
Surgery takes months to recover and often requires skin grafts and physical therapy. With the NA technique, the hand is bandaged for just a couple of days. Patients can perform stretches without a therapist.
Mike Smith
"I'm very satisfied with the outcome."
It's no wonder. Mike's finger went from this -- to this. And another patient's fingers, severely contracted before the procedure, now look like this.
Another advantage of this technique is that it requires no hospital stay. Dupuytren's strikes men twice as often than women. It is most common in populations of northern European descent and tends to run in families.
DUPUYTREN'S CONTRACTURE: The American Academy of Orthpaedic Surgeons describes Dupuytren's contracture as an abnormal thickening of tough tissue in the palm and fingers. This can cause the fingers to curl. This disorder is more common in men than in women. It becomes more common with age. What causes Dupuytren's contracture is not known. Doctors do know it is most common in people of Northern European or Scandinavian ancestry. It is associated with smoking and drinking. Certain medical conditions such as diabetes, thyroid problems and seizures also put people at higher risk. This condition usually occurs gradually. Doctors say it may start as a small tender lump in the palm. Tough bands form, causing the fingers to bend toward the palm. The ring finger and pinkie finger are most commonly affected. Surgery is usually recommended when the patient cannot straighten the fingers and has significantly limited hand function.
TREAMENTS: According to The American Academy of Orthpaedic Surgeons, surgeons will treat Dupuytren's contracture by dividing or removing the thick bands that are bending the fingers. In some procedures, the surgical wound is left open and allowed to gradually heal. Skin grafts are sometimes needed. Risks include nerves and blood vessel damage and infection. Swelling and soreness is expected, but severe problems are rare. Cosmetic surgeon Keith Denkler, M.D., says the possible nerve damage is unacceptable to some people. "What they do with traditional surgery ... They start to cut here and zigzag down and filet open the finger, core it out and restitch the skin," says Dr. Denkler. With traditional surgery, 10 percent of patients see little or no improvement. If the surgery is not a success, splints may have to be added.
NEW TREATMENT: Dr. Denkler says a new way to correct the deformity offers faster recovery. It's called needle aponeurotomy. Instead of a scalpel, Dr. Denkler inserts hypodermic needles to cut the contracted tissue and straighten the patient's fingers. The hand is numbed with local anesthetic. Traditional treatments will often takes months to recover from. Skin grafts and physical therapy are often needed. With the needle aponeurotomy, or needle release, the hand is bandaged for just a couple of days. Patients can perform stretches without a therapist. The treatment originated in France. Research has shown the procedure must sometimes be repeated several years later. As much as 50 percent of patients will need the procedure again in five years.
ADVANTAGES:
No hospital stay
Usually no physical therapy
No scarring
Less invasive
Faster healing
Keith Denkler, M.D.
Plastic Surgery
275 Magnolia Ave.
Larkspur, CA 94939
(415) 924-6010
http://www.AestheticSurgery.com
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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