HOW TO PREPARE FOR NEEDLE APONEUROTOMY

Eating

You are allowed to have a light meal at least 30 minutes before the procedure.  You will be in a reclined position for the procedure, so if you have problems with acid refulx after eating you should use your doctor’s recommendations regarding eating and lying down.

Relaxation

We do not use sedation for the procedure so you will be wide awake and conversing with Dr.Grabow during the procedure. Your cooperation during the procedure is essential to maintain its safety.  If you take anti-anxiety medications (Valium, Xanax, etc.), or need to take these medications before dental procedures, it is a good idea to take them before the procedure. Getting a good night sleep the night before and focusing on positive thoughts will help to reduce any anxiety you may have. Our clinic is located within a spa setting to help our patients have a relaxed and stress-free procedure.

Pre-procedure Antibiotics

If your doctor recommends you take antibiotics before dental procedures, because of joint replacement, heart disease, or other medical problem, it is appropriate to take that medication before this procedure.  Dr.Grabow cannot prescribe this medication before seeing you as a patient, so you will need to obtain prescriptions for these medications before your procedure visit.

Stopping Current Medications

Usually you do not need to stop any of your home medications. If you take medications such as aspirin, vitamin E, or blood thinners such as Coumadin, Plavix, or Fragmin let us know prior to your visit. If your medication levels are appropriate, usually they do not need to be stopped prior to this procedure.

Skin Problems prior to the Procedure

The skin on your hand must be clean and free of recent problems prior to the procedure.
Injuries, wounds, burns, insect bites, or healing areas involving the palm may prevent you from having the procedure. Contact us if your skin condition is in question.

THE OFFICE VISIT

How long does it take?

Usually the entire encounter takes about 2 hours.

Examination and Discussion

The first portion of the office visit consists of review of your medical history, examination, photography, measuring your fingers, planning the procedure, and discussion of the nature of Dupuytren’s disease, treatment options, possible complications, probable outcome, and answering any other questions that you might have.

Procedure

The second portion of the visit is the actual procedure, followed by final photography, review of outcome and aftercare
 

THE PROCEDURE

What actually is done?

You lie down on the exam table with your back, neck, and legs supported.  Small marks are made on your hand with a marking pen to plan the location of needle entry.  Your hand is cleaned with antiseptic and positioned on sterile towels. Your skin will then be numbed at the pen marks with a tiny needle and local anesthetic.  Using a needle in the areas that were numbed, the cords under the skin are cut.  At the end of the procedure, anesthetic and steroid (kenalog) will be injected into these areas to prevent pain and swelling.

What do I do during the procedure?

We want you to be relaxed during the procedure.  Dr.Grabow will play soothing music during the procedure per your request, and will encourage you to talk as much or as little as you desire.  In order to help minimize the chance of nerve irritation or injury you will need to tell Dr. Grabow if you feel anything painful, and specifically if you feel any tingling or numbness in your fingertips.

How painful is it?

There is only intermittent discomfort during the procedure.  The shots sting for a few seconds and then the skin is numb.  The cords do not have feeling so it does not hurt when they are cut.  If your joints are very bent, they will hurt to be stretched.  A small amount of anesthetic and steroid is injected into the joint prior to stretching it.

What will my hand look like after the procedure?

If everything goes as planned, your fingers should be straighter.  The needle sites will be covered with small adhesive bandages. Your fingers will have some degree of numbness from anesthetic given at the end of the procedure.  This may last until the day after your procedure.