Dupuytren's Contracture is a common problem that develops most frequently after age 40. It is more common in men than women, though both can be affected. It is usually hereditary occurring in people of European and Western Asian ancestry. It is unusual in Oriental or African-Americans. Dupuytren's usually starts as a painless nodule in the palm. It can progress to fibrous cords extending into the fingers, most commonly ring and little. These bands can cause contracture of the fingers. It can progress slowly or rapidly. The flexor tendons are not affected.

Partial palmar fasciectomy, the traditional treatment for Dupuytren’s Contracture, is performed at Central Jersey Hand Surgery by highly skilled board certified Hand Surgeons. The diseased contracted fascia is excised and the fingers carefully straightened.

Needle Aponeurotomy (also known as NA), a minimally invasive treatment, has been available at our Northeast Center for Dupuytren's Contracture since 2005. This treatment was developed by Dr. Lermusiaux at the Hôpital Lariboisière in Paris, France and has been performed for over 30 years. Dr. Lermusiaux and his colleagues have published data describing the success and safety of the procedure.

Dr. Pess and Dr. Atik have both visited Dr. Lermusiaux in Paris and were personally instructed in the technique. The treatment can be performed on one hand at a time, takes ~15-20 minutes and can be done with or without light sedation. There is no incision and no sutures are necessary. A light dressing is applied and the fingers can be moved immediately. Over 3,000 fingers have already been straightened safely utilizing NA.

NA was featured in the New York Times. Dr. Pess and Dr. Atik are listed as two of the Certified Hand Surgeons in the USA who perform the procedure.

In May of 2008, Dr. Gary Pess presented his preliminary results of NA at the Nineteenth Annual Richard J Smith, M.D. Resident and Fellows Conference at Massachusetts General Hospital in Boston, MA.

Click here for a Handout of the talk

In September of 2008, at the Sixty-Third Annual Meeting of the American Society for Surgery of the Hand in Chicago, IL, Dr. Gary Pess presented his prospective study: Needle Aponeurotomy for the Treatment of Dupuytren's Contracture. This was the first presentation of American data showing the clear benefit of NA. All patients had a follow-up of at least 2.5 years.

Click here for the complete PowerPoint Presentation

NEEDLE APONEUROTOMY PROCEDURE

Click on one of the videos below to see a video of the Needle Aponeurotomy Procedure.

Dr. Pess

Dr. Atik

If you are interested in having NA performed by Dr. Pess or Dr. Atik at our Northeast Center for Dupuytren's Contracture, please email photos along with a brief description of your problem and a list of any past surgeries on your hand. This can be sent to one of the email addresses noted below.

Dr. Pess and Dr. Atik


Please take photos shooting down on the palm with the palm facing up. A close-up of the diseased area and a side view are also helpful. Do not send photos of the back of the hand. If you cannot email the photos, they may be sent by regular mail to our Eatontown office.

If you would like to start the scheduling process, please call Lisa directly at 732-542-4477 x206 or email her at: lisacjhs@gmail.com.

A new treatment for Dupuytren's Contracture will be available at the Northeast Center for Dupuytren's Contracture in March, 2010. XIAFLEX is an FDA-approved nonsurgical choice for the treatment of adult patients with a palpable cord. It is directly injected into a Dupuytren's cord and works by enzymatically disrupting the abnormal collagen fibers. As a result of collagen disruption, the contracture may be reduced and range of motion improved. XIAFLEX may be used alone or combination with Needle Aponeurotomy. All of the Board Certified Hand Surgeons at the Northeast Center for Dupuytren's Contracture will be performing XIAFLEX injections.