John D. Mahoney, M.D., Dupuytren's Disease and Needle Aponeurotomy

home > Dupuytren's contracture > NA vs. open surgery

Needle Aponeurotomy vs. Open Surgery

Is needle aponeurotomy better or worse than open surgery? This is a difficult question to answer, because there are many factors to consider. Which treatment is better for a particular patient depends on the patients age, medical conditions, and personal preference. The chart below helps to summarize some of the advantages and disadvantages of each procedure.

Factor	NA	Open
Recovery time	Short - full activity within several days	Long - Full activity may be delayed for several weeks
Recurrence	Common - about 40-50 % at 3 years	Common - about 20-40% at 3 years, 35-60% at 5 years
Initial Results	Great for MCP joints, fair to good for PIP joints	Great for MCP joints, good to excellent for PIP joints
Complications	Rare and usually minor. Most common is small break in skin. Nerve laceration less than 1/500.	More common. Major complications about 5-7% overall. Nerve laceration 1-3%.
Repeat procecure	Possible, usually not more difficult than first procedure	Possible, usually much more difficult than first procedure. High complication rate.
Direct cost	Less expensive - only procedure and office visit fee	5-10 times more than NA when OR fee, anesthesia, and therapy included
Indirect costs	Low - patient usually able to return to work within days	Higher - patient may need prolonged time off from work

Case Example

Additional photographic case examples available in the Needle Aponeurotomy section of the photo gallery. This series of photos is from an actual patient treated by Dr. Mahoney.

Needle Aponeurotomy vs. Open Surgery

Case Example

Before

Immediately After N.A.

Six days after N.A.