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dupuytrens uk changing the world, one finger at a time… collagenase needle aponeurotomy na protocol na pre surgery information radiotherapy surgical treatment enquiry form how to contact us site map welcome welcome to dupuytrens.co.uk . this site aims to be the one stop website for british dupuytrens information. please feel free to look around and contact us if you want more information. what is dupuytrens? • dupuytrens is a condition characterised by fibrosis of the palmar aponeurosis leading to contracture of the fingers surgery has been the standard treatment for many years but realisation that the results of surgery are not as good for the patient as many of us have thought has lead to an increasing interest in alternative treatments both medical and non medical. here we will try to give you the lowdown on all the treatments available and tell you if they are safe or not. if you want surgery or another form of treatment, we can arrange treatment for you at our clinic in derby. news!! we now have approval for collagenase on the nhs in derby. you can ask your gp to refer you using the address here the good news is that dupuytren's disease is treatable! we can now improve the position and function of almost any affected finger no matter how long it has been affected. the bad news is that it is not curable at the moment. i prefer to talk in terms of controlling dupuytrens. every patient with dupuytren’s will experience recurrence after treatment or extension into another area of the hand. if you are lucky and have a mild form of the problem this might not be for 20 years. for some people this might be very rapid - 6 months. there are a large number of treatments available for dupuytren’s which have developed over time. these range from the legendary (letting a bishop kick your hand) to the barmy. most techniques today depend on some form of surgical intervention allied to splintage which may slow down the rate of recurrence although we have no evidence to support such a view and increasingly i do not use splints! surgical techniques have ranged from simply cutting the band in the palm, originally described by sir astley cline to major surgical interventions, removing significant amounts of the diseased skin and replacing it with skin grafts. like most areas of surgery interest is slowly increasing in less interventional techniques such as needle aponeurotomy and collagenase. like any other form of surgery you should check how often your surgeon carries out the planned operation and the possible complications. for dupuytren’s surgery i would have no hesitation in stating that your surgeon should be a specialist in hand surgery. this is not the place for a general orthopaedic or plastic surgeon, your hand is too important. to find a surgeon you can look on the british society for surgery of the hand website, the society do not offer any guarantee of ability but all members have expressed an interest in hand surgery and carry out a substantial amount in their nhs practise. all surgeons in the uk carry out fasciectomy in one of its forms but very few carry out na. there are now a few surgeons performing needle aponeurotomy in the uk but i think we have done more in derby than anywhere else in the uk. radiotherapy is carried out in europe for dupuytrens disease and the national institute of clinical effectiveness have accepted its use in the uk. there are now at least two radiotherapists offering radiotherapy in the uk minimally invasive techniques needle aponeurotomy , this is the standard minimally invasive treatment and works extremely well for most people. collagenase , a powerful new treatment that has only been licensed for 1 year but which offers major advantages for many patients. radiotherapy , a possible way of slowing, possibly preventing the need for surgery traditional techniques fasciectomy and dermofasciectomy are the standard procedures. i have performed these procedures hundreds of times and still use dermofasciectomy on a regular basis for severe dupuytrens. my view now is that fasciectomy has very little place in the management of dupuytrens compared to na, collagenase and dermofasciectomy. i use dermofasciectomy to treat patients with aggressive disease who cannot gain control of their disease any other way. how to book for treatment © 2013 lc bainbridge contact me

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