NA FOR DUPUYTREN'S CONTRACTURE OF THE HAND AND FINGERS Minor surgical release of Dupuytren's Contracture under local anesthesia as an office procedure. Uses small hypdermic needles to cut the affected tissues, a needle fasciotomy, as opposed to opening up and excising the diseased tissues which is called a limited fasciectomy. A fasciectomy is usually performed in a hospital or outpatient surgical center under regional or general anesthesia. This office is one of the few which can perform surgery for Dupuytren's under strictly local anesthesia. However, needle releases, (NA) are the first surgical procedure of choice. Safety The most common complications after NA are skin tears 15%. Other more uncommon complications include sensory nerve injury 1-2%, bleeding 1%, localized infection 1%. Rare and remote complications would inclued tendon ruputure 0.1%, NA does not cure Dupuytren's, and neither does surgical excision. Both are performed to straighten the fingers, however open surgery is a major operation. Recurrence may occur after surgery or a NA procedure, but it would be more common after needle releases and more common after NA for PIP (middle) joint disease. Insurance Coding: Diagnosis 728.6 (Dupuytren's) Procedue coding: 26040 (Percutaneous Fasciotomy) In longstanding contractures, needle releases of the joints of tendons may be necessary. NA or needle aponeurotomy may be combined with Kenalog(cortisone) injections of Dupuytren's nodules. Price: 750 for first digit then 375 for each subsequent digit. Insurance may or may not cover this. Medicare covers needle release procedures. If in doubt, please call your insurance and see if procedure 26040 is covered and to what degree by your plan.