New Procedure for Debilitating Hand Disease

Armen Hareyan's picture
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Dupuytren's disease treatment

An aging population is turning to an innovative treatment for the debilitating hand disease known as Dupuytren's contracture. Hand surgery specialist Dr. Charles Eaton M.D., followed a lead on the Internet to become the first surgeon in America to perform needle aponeurotomy, a less incapacitating and less expensive treatment for patients.

Dupuytren's disease causes a shrinking of a layer of flesh just beneath the skin of the palm, eventually making it impossible to straighten the fingers. Standard treatment is extensive surgery, with large incisions in the palm, prolonged therapy, and many months of recovery.

This contrasts dramatically with Dr. Eaton's minimally invasive approach, performed in his Jupiter, Fla. office with local anesthesia, in which he releases tight bands of abnormal tissue, leaving only pinhole wounds in the palm. After needle aponeurotomy, most patients are able to use the treated hand immediately for most normal activities, without physical therapy, and without the usual risks of traditional surgery.

"Many patients struggle for months after traditional open surgery for Dupuytren's contracture, and feel that their cure was worse than the disease. This new procedure allows patients to improve their hands in one step without having to disrupt their lives for months at a time recovering from each surgery," said Dr. Eaton.

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The Internet was the link to bringing this procedure to America. Although the technique had been available in Paris for thirty years, it had little mention in English surgical literature, a situation Eaton describes as an example of how the standard lines of medical communication can fail to cross the borders of countries and languages.

Instead, he learned of the technique through an online discussion group, and traveled to France in 2003 to learn the procedure first hand. Since then, he has performed needle aponeurotomy on over 1600 hands-on patients from five continents. He rapidly developed a global practice using his Web site and e-mail to communicate with patients from his office in Jupiter, Florida. Most of his patients have learned of his procedure online and travel for their treatment. Embracing an international Internet-based medical practice, Eaton said that he is now focusing his entire effort on treating patients with Dupuytren's contracture.

"The Internet gives patients options no one physician can offer - it's medical empowerment for baby boomers, " he said. "People want the freedom to choose their own medical care from the ground up. This procedure isn't magic or a cure-all, but it is a real option."

He said that the Internet also enables him to greatly reduce the time before he sees a patient and the need and expense for them to travel for an initial evaluation. For long distance triage of prospective patients, Eaton, an amateur programmer, wrote a web-based medical questionnaire program which guides the patient through an interview with the same questions and the same logic that he would use if the patient were in his office - thorough, consistent and reliable.

Dupuytren's disease most often affects adult men of European descent. It is painless and benign, and its severity varies from person to person. Advanced cases may cripple the hand. It's a baby boomer condition: in the United States, nearly one in ten men over 50 have some evidence of Dupuytren's disease. Overall, one in ten people with Dupuytren's disease will have a severe enough problem to consider needle aponeurotomy.

For more information, visit The Hand Center Web site, http://www.handcenter.org

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