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In-Office Aponeurotomy

Hand with Dupuytren's contracture

UMV Health Network - CVMC orthopedic surgeon Christian Bean, MD is the only hand surgeon in Vermont who performs a needle aponeurotomy (NA) for the treatment of Dupuytren's contracture.

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Dupuytren's contracture is an inherited condition of the hand that causes the tissue just under the skin on the palm side of the hand to thicken and contract. In Dupuytren's disease, this tissue (the palmar fascia) can shorten dramatically, which can make it impossible to straighten the fingers.

Dupuytren's contracture can be treated with open surgery that requires extensive healing, or with a minimally-invasive procedure called a needle aponeurotomy (NA). Dr. Christian Bean, of UVM Health Network - CVMC Orthopedics & Sports Medicine is the only hand surgeon in Vermont who performs this relatively quick and painless procedure.

How is a needle aponeurotomy performed?

The goal of needle aponeurotomy is to make the bent fingers affected by Dupuytren's disease functional again by straightening them.  During NA, Dr. Bean makes microscopic puncture wounds in the palmar fascia and uses the tip of a needle to divide and lengthen the contracted tissue. Dr. Bean performs needle aponeurotomy under local anesthesia in the convenience of our office in Berlin, Vermont.

Needle aponeurotomy is typically performed in the early stage of Dupuytren's disease, although it can also be a valuable therapy for progressed stages of Dupuytren's contracture.

What are the benefits of needle aponeurotomy?

Because the procedure is minimally-invasive, there are many benefits of NA over open surgery:

  • It can be performed as an outpatient procedure in a doctor’s office.
  • There is minimal scar tissue formation.
  • It is a relatively quick procedure.
  • It requires only local anesthesia.
  • Recovery is fast, with very little downtime required.
  • NA is less expensive than surgery.
  • Dupuytren's is likely to recur, but NA can be repeated as often as necessary without cumulative side effects.
  • The procedure is fairly painless.
  • The rate of complications, such as tendon or nerve injuries, is at least 5 to 10 times less than with traditional open surgery.
  • Hand therapy is usually not necessary after a needle aponeurotomy.

After the procedure, patients should keep their affected hand elevated for two days. Patients can return to light work activities immediately, while strenuous work, sports, or hobbies are off-limits for one week.

To learn more about Dupuytren's Disease or go to  www.dupuytren-online.info.

If you are looking for relief from Dupuytren's contracture without undergoing risky hand surgery, please schedule an appointment with Christian Bean, MD at 802-225-3970 to determine if you are a candidate for the procedure today.