Needle aponeurotomy was developed by a group of doctors in Paris. It has become popular because of convenience and cost effectiveness. Needle aponeurotomy, or NA, can be performed during an office visit typically taking less than 30 minutes. There is no fasting necessary and the visit is similar to a dentist visit. The hand can be used immediately for light use, and usually a few days later for unrestricted use such as sports.
Needle aponeurotomy involves injections with local anesthetic and a small needle is used to divide the Dupuytren's cords the hand. Gentle manipulation is used to break the tissue, usually resulting in immediate improvement of motion. A simple dressing or BandAid is applied to the hand. The benefit is convenience, lower cost, and earlier return to work/activites compared to surgery.
There is a small risk of infection, nerve, and tendon injury. The most common issue is a skin tear that usually heals with simple wound care. Recurrence of the contracture can occur, and further treatment can be performed including repeat NA, Xiaflex injection, or open surgery.
Before and after pictures of needle aponeurotomy
For video examples of needle aponeurotomy click here: YouTube