Can Dupuytren's contracture be cured through NA method?
Q: My 67 years old father is suffering from Dupuytren's Contracture. Is the disease curable in India by the needle aponeurectomy (NA) method developed in France?
A:Dupuytren's contracture is a disease that is uncommon in India. It results from contracture of the tissues beneath the skin of the palm. This progresses very slowly affecting the ring and the little finger. The main problem with this disease is that it causes deformity of the fingers, with the deformed fingers coming in the way of normal hand functioning. There are associated problems, which could be present in the given patient. These include alcohol misuse with associated liver disease, a similar problem in the foot, a disease causing deformity in the male genitalia. Occupational exposure to vibrations has also been included in the etiology of the disease. The usual treatment has been, in early cases, stretching followed by splinting to prevent deformities and once the deformity is established, depending on the severity of the case and the age of the patient, partial or sub-total removal of the contracted fibrous tissue. The surgery is technically demanding with the possibility of skin breakdown, need for skin grafting and damage to nerves and vessels. The NA approach is a minimally invasive approach that is described very recently. NA, which stands for needle aponeurectomy, is a technique, which reduces the need for open surgical release of the contracture by using the sharp end of a no. 25 (a fine gauge) needle. It is done as a day care procedure under local and superficial anaesthesia so that patients can inform about a possible damage about the nerves. As far as I know this is a new technique, which needs training and hands on skills. I am not sure of the possible places where it can be done in India. I don't think I can give you hope for a cure as yet because even NA provides symptomatic relief and not cure.