The Needle Aponeurotomy Procedure
The needle aponeurotomy, or needle release, is a non-surgical technique developed for the treatment of Dupuytren's contracture. The procedure releases the tethering cords that produce the finger contractures, thereby eliminating the deformity.
Utilizing a very fine hypodermic needle, select areas of the palm are anesthetized. Multiple painless perforations are made beneath the skin into the contracted Dupuytren's cords. The small holes weaken the cords substantially. When the doctor straightens the contracted finger, the weakened cords separate. The tethering cords are no longer intact to pull the finger into a contracted position. The correction is immediate. The tethering chords initially seen and felt easily in the palm retract usually making them neither visible nor palpable.
The treatment by needle aponeurotomy normally is painless both during and after the procedure rendering analgesics generally unnecessary.
The recurrence rate for the needle aponeurotomy is similar to that found after open surgery. Overall it is 30-50% after five years. However, the recurrence rate and disease extension is greater in certain individuals said to have a "Dupuytren's diathesis." This diathesis, or tendency for recurrence, is more common in those who experience any one or more of the following:
- early disease onset
- bilateral hand involvement
- little finger involvement
- knuckle pads
- Ledderhose disease (foot nodules)
- involvement of the thumb and index finger.
This tendency is not present in those with a family history of Dupuytren's disease.