Dupuytren's contracture is a tightening and thickening of the fibrous tissue layer underneath the skin of your palm and fingers, which can cause your fingers to curl. Needle aponeurotomy is an in-office procedure that uses a needle to perforate and weaken the contracted cords of fascia so that your fingers can straighten.
A needle aponeurotomy (ay-po-ner-AH-tuh-mee) is a procedure to straighten fingers that have become bent due to a condition called Dupuytren’s (doo-pooy-trans) contracture. This procedure is sometimes called a percutaneous needle fasciotomy (PNF).
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Dupuytren’s contracture is a disease of a structure in the palm. Specifically, the fascia, a fibrous tissue layer underneath the skin of your palm and fingers, thickens and tightens. This causes your fingers to contract or curl. Your contracted fingers affect your ability to perform such daily tasks as reaching into your pockets, putting gloves on, clapping your hands or holding large objects.
Treatment options for Dupuytren’s contracture include surgery (removal of the diseased fascia), injection of collagenase (a drug to dissolve the fascia) and needle aponeurotomy. Unfortunately, there is little benefit from therapy, stretching exercises or cortisone injections (except for the occasional painful palmar nodule). Treatment choice depends on the degree of contracture, joints involved, and number of fingers affected.
During a needle aponeurotomy, a small needle is used to perforate (make holes in) and weaken the contracted cords of fascia so they can be stretched to allow the fingers to straighten.
Your healthcare provider will review pre-treatment steps with you. Before any medical procedure, you should:
A needle aponeurotomy takes place at your healthcare provider’s office. It’s an outpatient procedure — you go home the same day. The procedure should take less than one hour.
During the procedure, your provider:
You are seen in occupational therapy for fabrication of a custom splint to help keep your fingers straight.
Before and after surgery for Dupuytren’s constricture
After a needle aponeurotomy, you can expect to:
A needle aponeurotomy is a relatively safe nonsurgical procedure to release palm and finger contractures. It’s less invasive than removal of the diseased palmar fascia, and has a much quicker recovery.
Potential risks of a needle aponeurotomy include:
A needle aponeurotomy is an effective treatment for people with mild to moderate contractures. You might need a more involved hand surgery if the contractures are severe. After the procedure, your fingers might not straighten completely. Contractures return within a couple of years in up to half of those who get needle aponeurotomies. The procedure can be repeated.
You should call your healthcare provider if you experience:
A note from Cleveland Clinic
When your fingers stay bent from Dupuytren’s contracture, it can be hard to work and do everyday tasks like washing dishes, driving and getting dressed. A needle aponeurotomy is a nonsurgical treatment that helps patients regain the ability to straighten their fingers, improving motion and function. Talk to your healthcare provider to see if this treatment can help you and to learn about other treatments for Dupuytren’s.
Last reviewed by a Cleveland Clinic medical professional on 09/21/2020.
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