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Treatment Risks

What are the risks of NA?

Recurrence

There is no cure for Dupuytren’s contracture. Nodules, cords, and contracture have a 50% recurrence in 5 yrs with open surgery and a 50% recurrence with Needle Aponeurotomy (Percutaneous Release) after approximately 3 years.  That does not mean it will come back,  but there is a good chance. Our treatment goal is to achieve straighter, more functional fingers.

Stiffness

Since Dupuytren’s more often effects older men, the presence of arthritis or hand stiffness in this population is not uncommon. This hand stiffness will not be improved with Needle Aponeurotomy.

After any hand procedure, some inflammation does occur. Needle Aponeurotomy (Percutaneous release) is no different. When a patient already has a reason for finger stiffness, an increase in inflammation of the hand can make the stiffness worse until the inflammation resolves. This is similar to someone with an arthritic hip or knee having pain and stiffness after a lot of walking.

Skin Cracks or Tears

The most common problem with Needle Aponeurotomy is that the skin of the palm may crack open when the finger is straightened. This happens in about one out of twenty procedures. This is easily treated with a small adhesive bandage (Band-Aid®) on the palm until it heals, typically in 7 to 10 days.

Nerve Injury

The Paris group reviewed their results of nearly four thousand Needle Aponeurotomy procedures in 1995 and found a less than one percent incidence of nerve injury. Infection, bleeding and tendon injury were also reported, but in much less than one percent of the procedures. These results compare favorably with the risks associated with open procedures for Dupuytren's contracture.

Infection

Any procedure that involves breaking the skin with a needle or knife has a potential for infection. The hand is cleansed with alcohol and iodine prior to the procedure and all equipment is sterilized.  However, infection is always a risk, although statistically less than 1% in all procedures.  In general, post-procedure infection in hand surgery is extremely low, even when one considers bigger surgeries with large open wounds.  Considering the minimally invasive approach utilized, infection is uncommon.
 
Tendon injury

Injury to soft tissue structures such as tendons, nerves, and blood vessels is a risk for all surgical procedures. Tendons can be partially cut or injured with a potential risk of rupture if they are weakened significantly. Like in all hand procedures, we take every precaution to minimize or eliminate these risks.


COMPARISON OF RISKS WITH OPEN SURGERY

Statistically, all the risks listed are over ten times more likely to occur with open surgery than with Needle Aponeurotomy.  Additionally, the significant risk of wound breakdown is almost twenty times more likely with open surgery versus almost zero risk in Needle Aponeurotomy, due to the lack of an incision.

 

Last updated 10.5.08


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