Needle fasciotomy (needle aponeurotomy) is a minimally invasive procedure to release Dupuytren's contracture by dividing the cord with a needle inserted through the skin, without a surgical incision.
Performed in clinic under local anaesthetic. A hypodermic needle is inserted through the skin at multiple points along the Dupuytren's cord. The needle is used to perforate and weaken the cord, which is then snapped by extending the finger. No incision or stitches are needed. The procedure takes 15–30 minutes.
Needle fasciotomy is suitable for well-defined palpable cords, particularly in the palm, in elderly patients, or those wanting a quick recovery. It is less suited for complex or recurrent disease.
Observation (if contracture is mild), collagenase injection (Xiapex, where available), and open fasciectomy for more definitive treatment.
Clinic-based procedure. No fasting needed.
Immediate correction of the contracture. Quick recovery with minimal wound care. Recurrence rates are higher than open surgery (approximately 50–65% at five years) but the procedure can be repeated.
Higher recurrence rate than open fasciectomy. Approximately 50-65% at five years.
Small skin splits at the puncture sites when the finger is straightened.
Local bruising and swelling.
The cord sits close to the digital nerves. Risk approximately 1-5%.
Very rare with proper technique.
At needle puncture sites.
The cord may not fully release.
Local anaesthetic infiltration only.
Immediate use of the hand. Night extension splint for three to six months. Hand therapy for stretching and range of motion. Return to work within days.
Review at two weeks with hand therapy. Splinting for three to six months.
Yes, recurrence is common (50-65% at five years). However, the procedure can be repeated if needed and has minimal downtime.
Needle fasciotomy offers quicker recovery with minimal wound. Open fasciectomy has lower recurrence but greater recovery time and wound complications.