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Chockstone Forum - Accidents & Injuries

Report Accidents and Injuries

 Page 1 of 2. Messages 1 to 20 | 21 to 23
Author
surgery review, needle job on Dupuytren's
mikllaw
18-Feb-2013
8:42:29 PM
I had hand surgery last week on my Dupuytren’s Contractures on one hand. It was painful but had a very quick recovery I had about 10 local anaesthetic injections in the palm, which is super sensitive.

There are 2 different main techniques, a "palm-off" (fasciotomy) which seems very good, but seems to take a long time to heal, or a needle aponeuroty which just cuts the tight areas with a needle. There are about little 14 holes where he did work, all pretty much healed up in 3 days. A very fast recovery is the main advantage.

Hand the day before surgery, 4 days after, and 11 days after

I have fair range of movement and will started some easy climbing after 10 days. I'm still weak, just like before, unfortunately.

Both methods of correction have a fairly high level of recurrence, so I'll report back in a few years.

Superstu
18-Feb-2013
9:04:18 PM
Looks like you'll be hand jambing again in no time mike!

Sounds like the surgery option for drupeys is still considered more reliable than the pharmaceutical option? Injecting acid into your hand sounds kinda cool though.

shortman
18-Feb-2013
9:27:56 PM
My juggling mentor had this and just learned to cope with surgery every few years. However, later in life it turned out to be diet related I think. As in changing his diet prolonged the space between surgeries. As you would know it takes a while before the hand become pretty much totally f#cked.

I could try and track him down to find out what he changed if you want?
mikllaw
18-Feb-2013
9:51:01 PM
On 18/02/2013 shortman wrote:
>My juggling mentor had this and just learned to cope with surgery every
>few years. However, later in life it turned out to be diet related I think.
>As in changing his diet prolonged the space between surgeries. As you would
>know it takes a while before the hand become pretty much totally f#cked.
>
>
>I could try and track him down to find out what he changed if you want?

So long as it isn't plonk or any member of the 'ch' food group (chips, cheese, chops, chicken, chorizo, champagne) I'm keen

IdratherbeclimbingM9
18-Feb-2013
9:52:32 PM
On 18/02/2013 mikllaw wrote:
>I had hand surgery last week on my Dupuytren’s Contractures on one hand.
>(snip)
Good to see you can slap the grasshoppers now instead of cupping them...
Cheers,
Idra~>M9

Eduardo Slabofvic
18-Feb-2013
11:06:55 PM
Getting old sux, doesn't it?
johnpitcairn
19-Feb-2013
6:37:25 AM
Booze has been implicated anecdotally. There's seemingly bugger all research around it, probably because it's an old working man's problem and nobody dies from it.

I've been afflicted with Dupuytrens since my 20s, in both hands and one foot (gulp), 2 surgeries to date at 50, contemplating my 3rd soon. Last was 7 years ago, before I started climbing, but I have some suspicion a hurried job left some of the fibroma in there and it reattached to an adjacent area.

The needling has never been suggested as an option here in NZ.

Shortman, I'd like to hear about your mentor's diet change.
technogeekery
19-Feb-2013
9:22:11 AM
Glad to hear that seems to have worked well :-)

Looked it up as I hadn't heard of this. Was wondering if it could be related to stress from climbing.

From Wikipedia: "Some suspected, but unproven, causes of Dupuytren's contracture include trauma, diabetes, alcoholism, epilepsy therapy with phenytoin, and liver disease. There is no proven evidence that hand injuries or specific occupational exposures lead to a higher risk of developing Dupuytren’s contracture, although there is some speculation that Dupuytren's may be caused by, or at least the onset may be triggered by, physical trauma such as manual labor or other over-exertion of the hands. However, the fact that Dupuytren's is not connected with handedness casts some doubt on this claim"

Maybe you are just lucky :P
technogeekery
9-Nov-2016
8:50:08 AM
Bugger, should have kept my mouth shut...



Thought I was developing callouses from increased training - turns out to be early stage Dupuytrens on both hands.

Mikl - how long did it take you from when you first noticed it until it needed surgical intervention? Anything you can do to slow the onset (not including stopping climbing)? Any good resources / info you've found for new players? 3 years post-op, how are you going with recurrence?

Cheers

Alex
johnpitcairn
9-Nov-2016
10:47:41 AM
Bugger indeed.

Mine *seem* to grow in bursts, with a growth stage triggered by repeated trauma on that area. In the past it's been guitar playing or use of tools, but for the one that turned up about 2 years ago I'm pretty sure it was poor technique with walking poles.

After they pop up, they quite often settle down and don't grow much for a while. I start to think about surgery when they are pulling the finger inward, or really consistently uncomfortable. Still haven't had the 3rd surgery, but the ones on my right hand index and middle fingers are getting annoying. For mine, looks like anywhere from 5-12 years seems to be the timeframe.

Climbing doesn't seem to be much of a factor, I climb mostly on the first 2 finger joints anyway.

Anecdotally, cut down on the booze if that's your thing. Stretching your fingers back will help slow the pulling in.
technogeekery
9-Nov-2016
1:41:21 PM
Thanks John, appreciate the info. I'm surprised at the lack of definitive information out there, so am very interested to hear anecdotal information from climbers. Cheers.
mikllaw
9-Nov-2016
6:35:56 PM
Mine was noticed in '92, then I degloved a finger in 96 and had the hand curled up in a splint for a few weeks, it was pretty bent after that.
Johnie2.5
9-Nov-2016
6:59:58 PM
Techno,

Like you i have this in both hands, my left looks exactly the same as your right and mine hasn't progressed at all in the last 12 years. So hopefully you can dodge the knife for a bit longer.
J
technogeekery
10-Nov-2016
10:16:18 AM
Thanks guys. After initial fear & loathing, I've done a lot more reading, and sounds like onset is very variable, and I probably shouldn't panic, just wait and see how it develops over the years - I might be one of the luckier ones.

ChuckNorris
10-Nov-2016
6:02:13 PM
I can 100% confirm that development depends on the individual. I've got it in both hands and had it diagnosed in one hand (looked exactly like yours below the ring finger) over 30 years ago as a teenager.

It was a bit random how I got my initial diagnosis as my old man got it and his hand curled up in a matter of years and he had to have surgery. The UK Dr treating him had written a few papers on treatment options and somehow the bumps on my hand got mentioned so he asked for a look - when he saw them he was a bit freaked out to see it in someone so young.

A few years ago my other hand started developing it (more toward the pinkie) but after the initial onset has been stable.

My completely unscientific thought is that climbing has helped a bit in the delay by breaking down and stretching the random connective tissue causing it, but ultimately you're dealt with what you've got. Hope yours stays as is.
maxdacat
11-Nov-2016
9:11:10 AM
Does this mean you no longer go by the nickname "Claw" ??
technogeekery
11-Nov-2016
10:27:24 AM
Thanks Stugang, interesting, and somewhat reassuring to hear of the variable and often very slow onset. Thanks for the good wishes - glad to hear yours is stable :-)

There is a very interesting paper in the British Journal of Sports Medicine on the potential causation of Dupuytrens from climbing - see http://bjsm.bmj.com/content/39/9/639.full It seems to confirm that climbing is a contributing factor with Dupuytrens, and can affect early onset and severity, particularly with more frequent and harder grade climbers.

I'm not reading too much into that, other than it confirms my suspicion that the disease is more prevalent in the climbing community than outside, and is likely hastened / made worse by the sport (rather than delayed as you propose). But given that I'm a gumby-grade climber and have a number of other risk factors (my Dad has a very mild presentation, I drink & smoked for years) I'm not saying climbing caused this. But as it has presented and progressed rapidly this year, coinciding with a big step up in my training schedule, I think it is very likely an aggravating factor.

Not sure what I'll do with this information - I'm training for a dream trip to Tuolumne / Yosemite next year, and will continue that - but will just keep an eye on it and see what happens.

For general interest - the conclusions of that research paper follows:

CONCLUSIONS

1) There is a higher prevalence of Dupuytren’s disease in committed male rock climbers compared with figures reported for most areas of the United Kingdom.
2) Climbers develop the disease at an earlier age compared with the general population.
3) The disease is more severe in climbers, with a greater proportion of finger contractures.
4) The greater the lifetime climbing intensity, the greater the likelihood of a climber having Dupuytren’s disease.
5) Specific hand injury is unrelated to the development of the disease.

This study therefore strengthens the hypothesis that repetitive strain to the palmar fascia over many years is a significant factor in the development of Dupuytren’s disease in men.

ChuckNorris
11-Nov-2016
5:37:41 PM
It's interesting that the trauma (climbing) influence is gaining popularity - as my old man was convinced his started cos of having to crank start our family car for many years (I come from a long line of Luddites - we got our first colour tv around 85). However his Dr at the time was dismissive of that suggestion.

Also I only got mine diagnosed serendipitously cos of the fact he had it severely when I was young. That was before I started climbing. However if my diagnosis didn't happenmy early onset was so mild I don't think I would ever have paid it much thought (even until now) unless I started climbing as it does ache a bit after a day of climbing. And if I hadn't had the diagnosis I would have been convinced my problems started when I began climbing. I haven't read the article (I will though as it's a sorta pet interest) but I'd be interested how/if they controlled for that type of selection bias.

One thing that I recollect is that it is more prevalent in Vikings - I have Viking blood and so do all the scummy climbers in England. So my alternate and preferred theory is that people whose ancestry includes the child of a woman raped by a Viking make awesome climbers.
One Day Hero
11-Nov-2016
7:50:10 PM
On 11/11/2016 Stugang wrote:
>So my alternate
>and preferred theory is that people whose ancestry includes the child of
>a woman raped by a Viking make awesome climbers.

So.....what percentage increase in grade do you think I could expect if I were to get raped by a Viking?

ChuckNorris
11-Nov-2016
9:31:33 PM
Good question but I have no idea. The only person I know with that sort of data is Eduardo and despite his decades of illicit affairs with Sven and co his grades remain flat.


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