Needle Aponeurotomy (NA) or Percutaneous Needle Fasciotomy (PNF) is an outpatient surgical procedure that was popularised in France more than 20 years ago.
The aim of NA is to straighten contracted fingers with minimal side-effects and with the help of physiotherapy achieve a functional finger/hand again.
A needle fasciotomy is the standard treatment for mild Dupuytren’s contracture. The procedure is sometimes also known as a Needle Aponeurotomy, or a Percutaneous Needle Fasciotomy (PNF) (percutaneous means ‘done through the skin’).
A needle fasciotomy is usually performed as an outpatient procedure. This means that you will not need to be admitted to hospital. You will be given a local anaesthetic that will numb your hand without making you lose consciousness.
During the surgery, a sharp blade or a very fine needle will be inserted into the fibrous bands (the cords) in either your palm or your fingers. This will be used to slice through the cord and divide it up under your skin. By cutting up the thickened tissue, your surgeon will release the tightness that was forcing your finger into the flexed (bent) position.
The benefits of needle fasciotomy include:
> a reduction in the deformity in your fingers
> a faster recovery compared with more extensive surgery
> it is suitable for people who are unable to have more extensive surgery, such as the very frail or elderly
> it has a low risk (around 1%) of complications
The rate of reccurrence for Dupuytren’s contracture is very high. As many as 50% of people who have a needle fasciotomy will have Dupuytren’s contracture again within 3-5 years. Often the needle fasciotomy is then repeated again.
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on this procedure.
Our treatment links page list some UK surgeons who have experience treating Dupuytren's.
A patient describes his experience of PNF here with some before and after photographs.
Examples with before and after photo's are available on our partner site.
For the non-squeamish, we show the links to some videos here.