General

Reimbursement for Needle Aponeurotomy and for Xiaflex
By: Charles Eaton
Feb 24, 2010

Needle aponeurotomy (NA) is referred to as percutaneous fasciotomy in the AMA Common Procedural Terminology (CPT) listing. CPT codes are the standard language used by health care providers and the insurance industry regarding reimbursement. Several years ago, Blue Cross of Massachusetts quietly removed the code for NA (26040) from their list of reimbursed procedures, as […]

Read more ›
Botox and Dupuytren’s
On: Jan 24, 2010
By: Charles Eaton

The holy grail of treating Dupuytren’s contracture is “disease modification”: how to stop progression or recurrence in a safe, nontoxic way? Three articles hint at the tantalizing possibility of the use of Botox (botulinum toxin) for Dupuytren’s. Botox includes two classes of enzymes which affect two different biologic systems. The first enzyme, which made Botox […]

Read more ›
Dupuytren’s Review
On: Jan 5, 2010
By: Charles Eaton

Despite being a visible, obvious problem, Dupuytren’s is difficult to understand, like the Jimmy Buffet line “so simple – like the jitterbug – it plumb evaded me”. It is helpful to review the basics on a regular basis to keep a clear perspective. Here is a great review for hand surgeons and non hand surgeons […]

Read more ›
Fifty years of Dupuytren’s Patients Reviewed
On: Jan 1, 2010
By: Charles Eaton

One of the more puzzling things about Dupuytren’s is the variation in demographic data. Taking away the variation in results from different surgeons doing different operations, one would expect a standard pattern of who is at risk, what conditions are associated. Not so. A review of nearly 3000 Dupuytren patients seen over 50 years at […]

Read more ›
Tissue markers for Dupuytren’s
On: Dec 27, 2009
By: Charles Eaton

Is it possible to predict the course of Dupuytren’s in an individual? Who will need surgery? Who will have rapid progression or an early recurrence after surgery and who won’t? Family and personal history provide general trends, but that’s all. Several studies have correlated the cellularity of nodule tissue and the presence of myofibroblasts with […]

Read more ›
Sex and Dupuytren’s in Boston
On: Dec 13, 2009
By: Charles Eaton

Dupuytren’s is fairly common in Boston, but seems different than the European flavor in terms of sex. The numbers on almost 2000 Boston Dupuytren’s patients were sorted out, and here’s how things roll in Boston: men develop Dupuytren’s almost twice as often as women, but it may seem like more because men tend to get […]

Read more ›
Looking at Dupuytren’s with MRI
On: Nov 29, 2009
By: Charles Eaton

Where is Dupuytren’s? It’s been known for some time that Dupuytren’s involvement can be identified by MRI, as described in these articles:http://www.dupuytrenfoundation.org/DupPDFs/1993_Yacoe_813.pdfhttp://www.dupuytrenfoundation.org/DupPDFs/1994_Miller.pdfand it’s likely that the activity of the process could be mapped, both for predictive value and for targeted treatment to prevent progression. Now, these papers are 15 years old – it’s time to […]

Read more ›
The Fish Technique for Dupuytren’s: Fasciectomy and Skin Graft
On: Nov 27, 2009
By: Charles Eaton

Skin grafts are used in a variety of approaches for Dupuytren’s: to add skin where it has been shortened (fasciotomy and skin graft, fasciectomy and skin graft); to replace skin where it has been removed to prevent recurrence (dermofasciectomy and skin graft). This study reviews the results of fasciectomy and skin graft. The recurrence rate […]

Read more ›