Needle aponeurotomy (NA) is a less-invasive treatment for Dupuytrens contracture. This procedure is performed under local anesthesia in the office. This procedure is also referred to as “percutaneous fasciotomy” by some surgeons. Using the tip of a syringe needle, the tight cords in the palm are perforated multiple times. Then the fingers are manipulated to rupture the cords, allowing the fingers to straighten. Light wound care and range of motion exercises are then performed, and sometimes a night splint is applied. NA is a less-invasive option available at Raleigh Hand.
NA is the least expensive treatment intervention for Dupuytrens contracture. The NA procedure has minimal recovery time needed. Most patients are advised to avoid heavy use with the hand for one week, but otherwise patients can use the hand for most light activities immediately.
NA is performed in the office but it is still a procedure with some risks. Skin irritation, pain, bruising, and swelling at the needle sites are common. These symptoms resolve and heal in a few days. Skin tears can occur as well, and these heal with daily wound care within about 2 weeks. More severe complications such as infections, injuries to the nerves and flexor tendons are very rare.
Not everyone is a candidate for the NA procedure. The best candidates have isolated metacarpophalangeal (MP) joint contractures and a palpable cord. Proximal interphalangeal (PIP) joint contractures are more difficult to treat with this technique since the digital nerves are nearby. Numbness in the finger can result after this treatment if a nerve is irritated or injured. However, some patients with PIP joint contracture are candidates for NA, depending on their specific condition. Recurrence rates are high for this technique as well as enzyme injections, but the procedure can be repeated in the future for recurrent contractures. Many patients choose either NA or Xiaflex injections as less-invasive alternatives to Dupuytrens surgery in the operating room.
Dr. Erickson uses NA, Xiaflex injections, and/or surgery to treat Dupuytrens contracture based on the unique aspects of each patient. Below is a picture of a patient treated with Xiaflex injection.
The information on this website is for general information only and does not constitute medical advice. Please consult with a qualified physician to learn about your condition and treatment options. Dr. Erickson and his partners at Raleigh Hand are members of the American Society for Surgery of the Hand.
Updated March 2026