Needle Aponeurotomy

Dr. Nguyen is proud to offer needle aponeurotomy as an office procedure for the treatment of Dupuytren's disease.  Since 2003, he has helped many patients with this debilitating disease by means of this procedure. Continue reading for more information on this exciting and relatively new procedure.

What is the needle aponeurotomy procedure?

Needle aponeurotomy (also known as percutaneous needle fasciotomy) is a minimally invasive procedure to treat Dupuytren's disease. The procedure originated in France in the 1950's with limited availability in the United States until the early 2000's. It is important to mention that this procedure is an alternative to traditional open surgery (see: Other Treatment Options and Risks). For the ideal surgical candidate, the procedure may offer the advantage of instantaneous results with very little risk.

The aim of any surgical treatment for Dupuytren's disease is to release the thick fascial cords that prevent the fingers from extending. The goal of the needle aponeurotomy procedure is to accomplish the release of this scar tissue less invasively.

Fig 4. Procedural demonstration of a needle aponeurotomy to release a Dupuytren's contracture of the ring finger.

Local anesthesia is given to make sure your hand is completely numb. A percutaneously-placed needle is then used to puncture and cut the band-like scar tissue structures beneath the skin, to weaken them. The weakened scar tissue is then able to be broken by mechanical force by manually extending the fingers. A characteristic "pop" or "snap" sound is often heard, signifying the breaking of scar tissue.  This allows the affected finger(s) to function again by allowing them to straighten and extend.  If successful, most patients experience an immediate reduction of symptoms. Additional cortisone (steroids) may be injected into the treated areas in an attempt to prevent reformation of scar tissue. The procedure only requires local anesthesia and is performed as an outpatient procedure in the office.

What are the risks of needle aponeurotomy?

It is important to note that the goal of this procedure is to restore some normal functional ability or symptomatic relief to the immobilized or painful hand of the patient. Unlike traditional surgery which surgically removes the restricting fascia, a needle aponeurotomy does not excise or remove any scar tissue. There is no "cure" for Dupuytren's, and some degree of disease recurrence occurs with all forms of treatment. Even in an attempt to reduce scarring by injecting Cortisone, it is well known and documented that recurrence of the contracture and/or symptoms following surgery is higher with the needle aponeurotomy procedure compared to the traditional open excision of scar tissue.  Despite this, the minimally invasive aspect of the needle aponeurotomy has many advantages (see: Why choose needle aponeurotomy?).

Risks with the procedure are signficantly lower than other available treatments for Dupuytren's disease (see: Other Treatment Options and Risks). Needle aponeurotomy does carry the same potential standard risks that are associated with any procedures which include:

•Pain (during the procedure and postoperatively)

•Bleeding/Hematoma

•Edema/Swelling

•Infection/Skin necrosis

•Underlying nerve or tendon irritation/injury

•Scarring at the needle insertion sites

•Resulting open wound from the needle release attempt

•Unsuccessful treatment of the contracture and need for further needle aponeurotomy attempts or additional procedures

•Recurrence of the contracture and/or scarring

 

Continue to "Other Treatments and Risks"

Return to "Signs and Symptoms"

Please call our office at (503) 635-1955 or send an email to tuananguyenmd@gmail.com to schedule a consultation and find out if you are a candidate for this procedure.

 

To learn more about Dupuytren's disease and  treatment options, Please Call or Email To Schedule A Consultation

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Additional Information

Please see the provided Additional Links and Resources about Dupuytren's Disease for additional information and references.