Surgical Information - Procedure

Needle Aponeurotomy

What is a needle aponeurotomy?

Needle aponeurotomy is a minimallyinvasive procedure to help straighten fingers that are flexed from Dupuytren's contracture, a thickening of the fibrous tissue layer underneath the skin of the palm and fingers. Dupuytren's contracture causes nodules and rope-like cords to form in the tissue. As the nodules and cords grow bigger, the fingers may curl permanently toward the palm.

In a needle aponeurotomy, the surgeon uses a small hypodermic needle to puncture the skin and divide and cut the contracted cords. The office procedure typically takes less than an hour with minimal pain and scar formation. Patients occasionally need one session of physical therapy afterwards so that a night brace can be made.

Anatomy

Dupuytren's contracture affects the palmar fascia, a reinforcing mesh that lies just beneath the skin of the palm. Dupuytren's causes this fascia to thicken and shrink, which pulls the fingers down into a bent position. Eventually, cords form that feel like strings under the skin

When is the procedure recommended?

Dupuytren's contracture usually progresses slowly and may not become troublesome for years.

In some cases, corticosteroid injections can help relieve pain and prevent progression of the disease.

If the condition worsens, pain intensifies or hand function declines, a needle aponeurotomy may provide relief.

What is the recovery time?

Needle aponeurotomy is a minimally invasive procedure performed in the physician's office. Patients typically return to normal activities right away and should avoid strenuous gripping for one week

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