1809 Brenner Avenue, Suite 102, Salisbury, North Carolina 28144

Needle aponeurotomy for Dupuytren’s disease

Dupuytren’s disease is a genetic disorder in which the tissue of the hand, also known as the palmar fascia, is tighter and, therefor, shorter than normal. The tightening begins in the palm and typically extends into the fingers. In severe cases, this tightening of the palmar fascia prevents people with Dupuytren’s disease from being able to flatten their hand, as their fingers are constantly in a contracted state. In addition to curling a person’s fingers towards their palm, Dupuytren’s disease also may cause painful nodules to sprout up in the palm.

The disease more commonly develops in older individuals and in people of eastern European descent. Women are less likely to be diagnosed with Dupuytren’s disease; however, when they do have it, symptoms tend to regress more quickly following treatment than in men. Though not strictly genetic, those whose family members have Dupuytren’s have a higher likelihood of developing the disease themselves. Additionally, those who are genetically predisposed to have the disease may develop symptoms following hand surgery or frequent involvement in vibrational activities, such as operating a jack hammer.

The traditional way to treat Dupuytren’s disease, called partial palmar fasciectomy, involves creating several large incisions through which the damaged tissue is removed. A patient’s degree of contraction must be severe before operative intervention is appropriate, due to the long rehabilitation time and invasive nature of the procedure. However, Carolina Spine and Hand practices a less invasive treatment method entitled needle aponeurotomy that corrects both mild and major contractures.

During needle aponeurotomy, the skin on the hand is numbed and a needle is inserted through very small stab wounds around the thumb and index finger. The needle is then maneuvered to separate parts of the palmar fascia, thereby lessening the tightness of the tissue and enabling hand extension. The entire procedure on average lasts about fifteen minutes.

In severe cases of Dupuytren’s disease, a cast may be added to the affected fingers before or after a needle aponeurotomy to assist with restoring normal structure to the hand and fingers.

The needle aponeurotomy typically restores complete or near-complete extension to the fingers and hand, depending on how involved the contracture is. However, the extension restoration is not permanent; no matter what treatment option is employed, symptoms of Dupuytren’s disease will always return. Fortunately, due to the cost efficient and minimally invasive nature of needle aponeurotomy, the procedure can be repeated to continue to minimize the symptoms of the disease.

The procedure is performed in-office and is less expensive and safer than most other treatment options such as those using the chemical Xiaflex.

Carolina Spine and Hand is currently the only clinic in Salisbury that offers this procedure.

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