Needle Aponeurotmy for Dupuytr… The contractures at the PIP (middle) joint can be very difficult to treat.  However, in some patients, dramatic improvement can occur. This patients hand is seen one month after Dupuytren's needle release of the little finger.  Significant gains in extension of the little finger have occured after needle (subcutaneous) fasciotomy for the contracture of Dupuytren.  The usual improvement is usually only about 50%.  That is, a 90 degreee contracture such as this would be expected to only improve to about a 45 degree contracture.  These lesser results are due to tight muscles and stiff joints due to lack of use.