My hands got worse after Dupuytren’s surgery, what can I do?

Posted on September 27, 2011March 20, 2012 by

Strategy to avoid risks of Dupuytren hand surgery

All surgery has risks. Even the most simple and direct surgery can result in an unexpected bad reaction. These can occur due to human error and judgment issues, or simply for reasons that are unavoidable and totally unexpected.

Complications after open hand surgery for Dupuytren contracture (palmar fasciectomy) is variously reported to occur in 17% to 41% of cases, clearly higher than for many other types of surgery. While the side effect and complication rate for needle aponeurotomy (palmar fasciotomy) is much lower at 2 to 4%, this must be weighed against its much faster Dupuytren recurrence rate and the need for additional palmar fasciotomy surgery sooner and more often.

It is important to understand that chances for adverse reactions after either of these two types of hand operations are at least doubled when performed as a second or third Dupuytren surgery. Simply stated: 1. The more often palmar fasciectomy or palmar fasciotomy are performed the riskier each succeeding surgery becomes, and 2. repeat hand surgery is performed because of the high rate of recurrence of Dupuytren contracture after surgery. With each surgery normal anatomy changes and less useable tissue remains. Sooner or later so little tissue is left for the next surgeon to use, until no more hand surgery can be done.

Avoid or delay palmar fasciectomy surgery with Alternative Medicine

Those considering a second or third Dupuytren surgery after a needle aponeurotomy (palmar fasciotomy) or open hand surgery (palmar fasciectomy), should be interested to consider natural Dupuytren treatment as a possible way to postpone or avoid another hand surgery.

To learn about Alternative Medicine self-management, please see Different Way of Looking at Dupuytren Contracture Treatment

Medical researchers, Loos, Messina, and Bulstrod report successful outcomes of Dupuytren treatment using massage, exercise and traction, all without surgery. Even so, not much interest is given to their work because research funding is always focused on high profile surgery and drug therapies. Natural therapies of Alternative Medicine are not a high profit way to treat Dupuytren contracture, although the Dupuytren Contracture Institute has been providing insight and assistance since 2002 to help people deal with their hand problems.

Not all people respond well to drugs and surgery, and not everyone responds to Alternative Medicine. And just as no one in the practice of medicine can say with certainty that any drug or surgery will be successful, no guarantee can be offered that non-drug and non-surgical natural methods will assist your recovery. Even so, the advantage of using a simple and low cost Alternative Medicine approach is that when it does successfully assist the body to recover from a health problem, the need for drugs and surgery is lowered, delayed or eliminated. Another major advantage is the well known low risk of natural therapy compared to drugs and surgery.

For those who have never had Dupuytren surgery, the conservative option is to undergo a short therapeutic trial of care with natural remedies first – rather than last – to possibly avoid hand surgery. For those who have had one or two Dupuytren operations, the conservative option is still open but with reduced expectation. In these cases the body has less normal tissue to work with; results cannot be as good as when surgery was never performed.

In the experience of the Dupuytren Contracture Institute working with those who have had one hand operation, it is possible to eliminate the need for a second surgery and cause doctors to change their recommendation for the need of a second surgery. With a brief trial of Alternative Medicine treatment it is possible to make positive tissue change and either avoid or delay the need for surgery.

Rapid recurrence of Dupuytren contracture means more hand surgery later

Many who write on Dupuytren’s forums express the cavalier notion that they are willing to submit to needle aponeurotomy every few years even though recurrence is more rapid with this type of less invasive hand surgery. They explain that they prefer NA because recovery is so rapid or they can use their hands in a few days with no rehabilitation. They fail to calculate that this does not necessarily happen each time needle aponeurotomy is done. They do not consider the risk of an adverse reaction increases with each surgery, preventing this approach to be used indefinitely.

For those who already have had one Dupuytren’s hand surgery and want to avoid another, this article presents possible avoidance options as well as the potential complications and risks of palmar fasciectomy, also known as Dupuytren’s contracture open hand surgery.

Bad reaction after Dupuytren’s surgery, what is next?

The idea that it is possible to correct a bad surgery with another surgery must be examined very closely. While there must be cases where this works out well for the patient, extreme caution must be used to assure a bad situation is not made worse by additional irreversible tissue changes of compounded surgery.

First, get a second surgical opinion but not for the reason many people think. Patients typically approach a second medical opinion only to see if it agrees with the first. This is often just another way of allowing two doctors to make a decision for a patient. The best use of a second doctor’s opinion is to receive additional medical information and a different view point to round out the thinking of the patient. Both medical opinions should supply information to help the patient decide the next step to take. It is the patient who must ultimately decide the best course of action to take to return to health. When the patient does not feel capable of making that kind of decision, it is the fault of the doctor who has not provided adequate information to the patient. Find another doctor who will talk to you and explain things in such a way that you can make this decision!

In no way is it suggested that a layperson can know more about the practice of medicine than the doctor. Even so, the layperson must ask questions and receive answers from at least two doctors so she is able to make an informed and intelligent decision about her care – not the doctor. A lazy patient does not get the best care.

It is the responsibility of the patient to assure that a second surgery is the best step to take – as it might be. Too often patients rely solely on the judgment of the first doctor they encounter to make important decisions for them. This is not wise.

If you do not like the thought of additional Dupuytren surgery, for whatever reason, you can consider attempting Alternative Medicine treatment for a month or two or more to learn if your body is capable of reversing the abnormal hand contracture. If it helps your situation and surgery is no longer indicated, look what you have gained. If it does not help, you can have surgery knowing you have not been hasty, you have used conservative measures appropriately, and whatever reaction occurs from a second surgery was indeed unavoidable because less aggressive measures did not help you.

Suggestions to determine if your body is capable of changing the soft tissue contractures in the palm and fingers:

1. Learn about your Dupuytren problem from a different standpoint. You were told you needed hand surgery by the MD who gave you the diagnosis of Dupuytren contracture. Almost all internet information about Dupuytrens promotes surgery. Go to the home page of the Dupuytren Contracture Institute for holistic information about day-to-day treatment. The information found on this website is unique because we present the idea that not all Dupuytrens needs surgery.

2. Determine the most aggressive Dupuytren therapy plan you are comfortable following. For best results do all that you can to help yourself. Consider using what is called the “Large (Best) Plan” for personal treatment. The “Medium (Better) Plan” is the most popular of the DCI plans. The “Small (Good) Plan” is also well designed. These three plans are found at the top of the page at Dupuytren treatment plans. Any plan can be modified by subtracting or adding to suit your personal Dupuytren contracture treatment philosophy. These plans are only examples of how to approach this problem, and have helped hundreds of people over the years.

3. Stop feeling discouraged. Read the Dupuytren Hand Bump Forum. Get educated, motivated, and reminded that everyday around the world there are people who are actually beating their Dupuytren problem following the Alternative Medicine methods of the Dupuytren Contracture Institute.

Complications of open hand Dupuytren surgery (palmar fasciectomy)

No one, not even a surgeon, can predict the side effects and complications of a particular surgery – and that is the problem. While many patients, even a majority, receive a palmar fasciectomy without an adverse reaction and no post-surgical complication at all, there are those who are worse after surgery. The number or percent of adverse surgical cases is not important if you are one of the unlucky patients whose outcome is poor. The only bad outcome that matters is your own.

Keith Denkler, MD, in 2010 wrote, “Surgical Complications Associated with Fasciectomy for Dupuytren’s Disease: A 20-Year Review of the English Literature.” His final comments,
“In conclusion, results of this study underscore the importance of
treating Dupuytren’s as an incurable genetic disease understanding that
surgical excision, fasciectomy, has a high rate of major and minor
complications. Surgeons must understand that while fasciectomy for
Dupuytren’s does offer a chance at long-term ‘straight’ fingers, there is
a high cost in terms of numbers of complications that are borne by the
patient.”

Because the hand is a highly complex and densely packed machine with practically no space separating very delicate nerves, blood vessels, muscles, ligaments, tendons, and fascia, the patient must carefully select the best surgeon for the best hand operation outcome.

The Dupuytren Contracture Institute is not against hand surgery. DCI only suggests it is a prudent step to first try Alternative Medicine to learn if their Dupuytren soft tissue problem is partially or completely reversible, thus making surgery unnecessary. If the need for Dupuytren hand surgery remains after natural methods has been unsuccessful, find the best surgeon possible.

Dupuytren surgery question

Posted on June 7, 2011 by

Dear Dr. Herazy,

My father has been diagnosed with Dupuytren’s some months ago, but only recently has complained about any pain. The pain is not unbearable, it is just a feeling to remind him that it’s there. So nothing big at the moment.
He wants to treat it, but he has asked me to investigate on when is the best time to have the surgery? His hand is still in the early stages of the contracture. Should he have the surgery as early as possible, or is it better to wait until his fingers are contracted more?
Thank you,

Partin.

Greetings Partin,

I must commend you on being a good daughter to help her father in this way.

You must remember that this site is devoted to the non-drug and non-surgical treatment of Dupuytren contracture. There are those cases that probably should undergo Dupuytren’s surgery, but in the opinion of DCI surgery for someone like your father should only be done after more conservative measures have failed to improve his situation.

Usually Dupuytren contracture is not painful, except during the early stages and then only for a limited time. Many of the cases whose hand pain persists and undergo our Alternative Medicine self-care report rather rapid and complete elimination of pain. If it is only pain relief that your father is interested in, he should not be overly concerned since this usually is self-limited after a short while. this process of pain relief is something that responds to well with our treatment measures.

Since Dupuytrens will return after all forms of hand surgery, given on average about five years, your father should understand that Dupuytren surgery is not an absolute final treatment for anyone. Typically, after the first surgery when the problem recurs it is a little worse and returns a little sooner after each surgery that is done

An orthopedic surgeon who works with Dupuytren cases will usually decide when and how to perform surgery on the hand based on several factors:

1. Age of the individual
2. Duration of DC
3. Severity of involvement
4. Degree of limitation of use
5. Degree of reduction of quality of life
6. Family history of DC
7. History of past injury and surgery to hand

While no specific rules exist that determine when Dupuytren surgery should be done, many surgeons recommend when the large knuckle of the involved finger reaches 30 degrees of flexion contracture. When the problem returns after surgery or causes more severe contractures after the surgery heals, fusion of the individual finger joints is sometimes recommended. In the worst case, finger amputation of the finger is recommended if the developing contracture restricts the blood or nerve supply to the finger. TRH

Natural Dupuytren Treatment: Average Time to See Results

Posted on March 28, 2011February 28, 2013 by

Dupuytren contracture difficult to predict in many ways

There are no dependable averages with Dupuytren contracture. Everything about Dupuytren hand contracture is variable, from speed of progression to how a person might develop the problem. And certainly, there is no average time within which a person responds to Dupuytren treatment using Alternative Medicine. Some people show early signs of improvement in a few short weeks, others take months, and some not at all.

There are those who write me an email at DCI to say they did not respond to Dupuytren treatment. After questioning them, I usually find they made the mistake of either using a very limited plan or not faithfully following the plan they put together. Dupuy can be a difficult problem to treat and it is necessary to be completely dedicated to eliminating the problem – partial or occasional efforts do not earn good results.

The Dupuytren treatment concept we propose is actually not very strange or extreme. All we propose is to do is to determine what natural vitamins, minerals, enzymes and herbal products, as well as exercises and things of that nature, you can use to promote and encourage your body to heal the Dupuytren hand and finger contracture you have.

Dupuytren contracture should heal like any other health problem

The Dupuytren treatment approach promoted by DCI is to do all that is possible to prepare the body to heal on its own, in as many small and large ways as can, to the best of its ability. It is really not such a crazy or extreme idea since cancers are known to self-cure and serious infections and diseases self-cure, why not Dupuytren contracture? DCI advocates that an aggressive use of multiple conservative Alternative Medicine therapies, as outlined in our website, can possibly assist the body to heal the contracted palm lumps.

Since 2002 it is my experience that those people who use the largest and most aggressive therapy plan will usually get the best results. For those interested in following an aggressive therapy plan to promote the best opportunity for healing and repair, the “Large (Best) Plan” is intended for maximum personal treatment. The Medium (Better) Plan is the most popular of the three plans offered by DCI. There is also a Small (Good) Plan that is well designed. Any of these plans can be modified in any way you wish. For example, it is common for people to substitute Neprinol in place of Nattokinase and Serrapeptase that are found in any of the plans.

Dupuytren contracture treatment to be effective must be followed aggressively and faithfully because DC is a stubborn problem that defies successful treatment. Be prepared to spend time and effort to build up the strength of the immune response if you wish to earn any level of correction. It can be done; I talk to people everyday who are doing it.

I would be pleased to answer any specific questions you have about Alternative Medicine treatment of the hand lump and finger contractures that plague you. Simply send your question at the end of this blog post.

I have worked with hundreds and hundreds of cases of DC, some mild and some severe, some just a few months and a few more than 10 years old. Because of this I know that success against Dupuytren treatment success seems not to be determined by how bad the problem is at the start of care or how soon you start treatment; success seems to be primarily determined by intensity of effort.

You do not have to feel like a victim if you are working to improve your health and immune response against the presence of this foreign tissue.

The DCI website offers ideas and information about natural healing of Dupuytren you will not find elsewhere. For help and ideas that you are not now getting, please send an email to contact@dupuytrens-contracture.com