Non Surgical Alternatives - Needle Aponeurotomy

The technique of severing the bands of facia in the hand using the sharp edge of a needle has been used in France for over thirty years (Lermusiaux published the first short-term and three years results in 1979). The technique has been called Needle Aponeurotomy by the French and Needle fasciotomy by the English. The Internet community seems to have settled on "NA", which is the term I will use on this web page.

NA is an outpatient procedure where one or more fibrous bands (contractures) are cut (sectioned) using a blade or a bevel of a needle. Section is achieved by moving the needle in a sawing motion against the fibrous band. This movement is repeated several times, each time after rotating the needle in a star-shaped pattern in the plane of the palm. Once partial section has been achieved the finger is extended causing the band to snap. A dry bandage is then secured by elastic tape and placed over the injection site for at least 48 hours.

The NA technique has been practiced by a group of rheumatologists in France. News of the technique has spread to the English speeking world primarily through the Internet. Several web sites describing personal experience with treatment in Paris ase listed in the Links page.

NA has been recognized by the National Institute for Health and Clinical Excellence (NICE) of the United Kingdom. NICE published an undated overview . Then, in the 2004 publication IPG043 "Needle fasciotomy for Dupuyren's contracture, guidance", NICE recognized NA and authorized medical insirance coverage. I cannot find similar recognition by an American institution.