Dupuytren's Treatments

Since I began researching Dupuytren's in 1998, I've learned about several treatments. Treatment is the operative word since there is no known cause or cure for Dupuytren's Contracture. Treatments include conventional surgery, topical verapamil, and needle aponevrotomy. I'm not including homeopathic remedies or other treatments here because I cannot speak honestly about their effectiveness.

Please note that these are MY experiences and/or opinions about the effectiveness of treatments. I encourage readers of my pages to visit the links and consult medical professionals of their choice before deciding upon your best treatment option. I'm not in the business of offering medical opinions for others.

Chiropractic

A local chiropracter had a free exam offer that I took advantage of. During the appointment he tried making several "adjustments" and we scheduled another appointment a week or so later. Next appointment he made more "adjustments", but no positive effect was noted so we both agreed that "adjustments" weren't an effective treatment. There was one posting on the BTC Dupuytren's Forum from someone who was treated successfully by a chiropracter. I talked to the doctor, from Kansas I believe. Since multiple treatments would be required over time and I live in Illinois I opted not to pursue this course.

Colleganase

Another POSSIBLE treatment is injectable Collegenase developed by Biospecifics Technologies Corporation (BTC). I call this a possible treatment because it has only been tested in a very limited series of clinical trials only and this is the only way you can obtain this treatment. I've posted the first-hand experience of a person who's had this treatment here.

Vitamin E--Oral and Topical

I tried a regimen of both topical and oral vitamin E....both 400 and 1000 IU. Oral vitamin E alone made no difference that I could tell. The topical vitamin E made my hand nice and soft and eliminated any dryness in the palm. It did nothing postive or negative (that I could tell) for the contracture.

Conventional Surgery

This should be a last resort option for anyone. If you visit the web site of Wheeless' Orthpaedics, you'll see what I mean. Look at the pictures and see if you don't think they remind you of deboning a chicken. There is no doubt that this is major surgery requiring a hospital stay, weeks of physical therapy, and the possibility of several serious complications. I encourage you to vist the BTC Dupuytren's Forum to read the numerous postings on this subject.

Topical Verapamil

This is a proprietary ointment developed and compounded by Prescription Dispensing Labs (PDL) in San Antonio Texas. I learned about this drug from a thread they started on the BTC Dupuytren's Forum. This is an attractive treatment option because it is a topical ointment that you apply 3 times daily. You can read the details at the PDL web site. Cost is approximately $200 for 2 ounces of drug and it requires a prescription from your doctor.

I decided to give this drug a try beginning in September of 2000 and applied it religiously as per the directions. I noticed no significant improvement in over 5 months of use. I did have some problems with the drug getting "grainy" and PDL always replaced the drug for free at their expense. They were very helpful and I recommend that anyone give this a try, especially if your contracture is in its early (Stage 1 or earlier) state. PDL says that results can take up to a year. I wasn't willing to wait. Although I'm continuing to use the drug to minimize recurrance, I opted in March for the most effective and immediate treatment: Needle Aponevrotomy.

Segmental Aponeurectomy

According to the information presented on Dr. J.P. Moerman's (the inventor of the treatment) website: "The basic postulate of this operation is that, if we can create a permanent discontinuity in the retracted aponeurotic band without wide dissection of the fascia itself, then the retracted band, from which tension has been eliminated, will disappear or at least cease to act as a contracture. The same principle is regularly applied in the treatment of hypertrophic scars. It is thus much more than a simple fasciotomy since we create a gap in the retracted aponeurosis."

Simply put, this treatment lies between needle aponevrotomy and full blown surgery in its complexity, risk, and effectiveness. You can learn more about the treatment here. This treatment appears to be currently available in Belgium only.

Needle Aponevrotomy

Also known on the web as "The French Connection" this treatment offers those of us afflicted with Dupuytrens the most immediate and highly effective solution currently available. The treatment is inexpensive ($150.00 per 20 minute session), an outpatient procedure, and offers immediate results with NO physical therapy required and minimal, if any, complications. So, why don't all Dupuytren's suffers opt for this? The treatment is only performed in Europe, primarily France.

Keep in mind that Needle Aponevrotomy is only a treatment and not a cure. Since the cords are not removed, only severed, and the cellular/metabolic cause is not cured it's possible the condition will recur over time. However if you're looking for excellent short term relief from the condition, this is the "magic bullet" that you're looking for.

Why isn't the treatment performed in the US or Canada? Good question. I can only speculate that there are several reasons. First, the procedure was only documented in English ONCE in a French medical journal. Second, Dupuytren's Contracture is not life-threatening and compared to other health problems there aren't that many people who have it. You can interpret this as "there's no money in it." Third, it's too simple and it it can't possibly work. WRONG! Everyone I've spoken with who's had the procedure would do it again in a heartbeat. Also, unlike conventional surgery it can be performed multiple times without complications.

Don't look for this treatment to be offered in the U.S. or Canada. Think vacation. Think France.

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