What is needle aponeurotomy?

Needle aponeurotomy is a procedure used to straighten bent fingers caused by Dupuytren's (say "duh-pwee-TRAHNZ") disease.

This disease can change how your hand looks. You may find it hard or impossible to use one or more of your fingers.

The disease causes tissue under the skin of the palm of your hand to thicken and shorten. This can pull and bend the fingers in toward the palm. You may not be able to straighten them. This is called a contracture.

Your doctor will numb the affected area of your hand. He or she will then place a needle into the tissue that is bending your fingers. Your doctor will use the needle to put holes in the tissue. Then the doctor will straighten your fingers. This causes the tissue to separate and release your fingers.

The procedure causes little pain. But your fingers may be numb for a few hours after the procedure. You may notice tingling in the fingers for the next few days.

After the procedure, your doctor may inject corticosteroid medicine in your hand. This reduces swelling. You will have bandages put on your hand.

The procedure can be done in your doctor's office. It takes 20 to 30 minutes.

It will probably take about 1 to 2 weeks for your hand to heal. How soon you can go back to work depends on your job. If you can do your job without using your hand or with light use, such as working at a computer, you may be able to go back in 1 to 2 days. But if your job requires you to use a lot of hand strength, to grip things tightly, or to get your hands dirty, you may need to take about 1 to 3 weeks off work.

For the first few weeks after this procedure, you will probably need to wear a splint part of the time. You may need to do hand exercises to help reduce the swelling and stiffness.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before the procedure?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your procedure. Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
• If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of the procedure?

• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the doctor's office or surgery centre

• Bring a picture ID.
• The procedure takes 20 to 30 minutes.

Going home

• Be sure you have someone to drive you home.
• You will be given more specific instructions about recovering from your procedure. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your procedure.
• You become ill before the procedure (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the procedure.