Tag Archives: Needle Aponeurotomy

Needle Aponeurotomy: A Nonsurgical, Minimally Invasive Approach Toward Duputyren’s Contracture

Before and after photos of patient hand

Showing contracture and post-aponeurotomy of a patient who has been able to resume full activity.

Duputyren’s contracture, a genetically-influenced disease marked by overgrowth of fascia in the palm and fingers, can lead to markedly diminished hand function. Currently there is no cure; even with open surgery, contracture can recur. A nonsurgical approach toward Duputyren’s contracture, needle aponeurotomy, is gaining acceptance as a low-risk, low cost treatment strategy. Michael Darowish, M.D., Penn State Hershey Bone and Joint Institute, trained at the Cleveland Clinic with Avrum Froimson, M.D., a leading expert in aponeurotomy. Darowish explains, “Aponeurotomy is performed in the clinic. I use a fine, 25-gauge needle inserted under the skin. This is swept back and forth to divide the collagen cords that cause finger contracture. I begin distally, injecting a small amount of lidocaine into the skin over the cord, then inserting the needle and dividing the cord. This is repeated at a number of sites, proceeding proximally toward the palm. A small amount of kenalog is injected at the conclusion to soften any remaining nodules.” Continue reading

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