WHAT IS NEEDLE APONEUROTOMY ?
Needle aponeurotomy is an outpatient procedure in which fascia contractures are sectioned percutaneously with the sharp-edged bevel of the needle used for the injection of a local anaesthetic.
Sectioning of the bands is achieved by sawing and perforating motions of the needle.
Resistance due to the cord is clearly felt and this sensation is easily recognized by experienced operators.
Rupture of the cord may be completed by extending the digit until the band is torn with a characteristic snap.
Contractures are always sectioned in the same order, from the proximal to the distal palm and if necessary to proximal phalanx.
When the treatment is over, a dry dressing (secured by elastic adhesive tape) is applied which must not be removed for three days. The patient is instructed not to wet or soil his hand for this period.
At the end of the session, which lasts about 15 minutes on average, the patient can use the hand for most normal activities, with the exception of heavy lifting or pressing which must be avoided for about 10 to 15 days.
This treatment usually requires neither sick leave nor rehabilitation.
For stages III and IV of the disease, with capsular contractures of the P.I.P joint, use of an extension orthesis during the night may be useful to achieve the desired result.
Most patients could be treated within three sessions.
This technique is currently performed in France, Belgium, Switzerland and Italy.
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