Under the surgical microscope, the transverse, longitudinal and vertical fibers of the palmar tendon membrane can be completely removed, effectively protecting the vascular nerve bundle, reducing postoperative hematoma and skin margin necrosis with minimally invasive operation, facilitating the recovery of finger function, and reducing recurrence. The main pathological basis of metacarpal tendon contracture is myofibroblasts, which exist not only in the metacarpal tendon membrane but also in the subcutaneous connective tissue and dermis, and the affected subcutaneous tissue and dermis should be removed to avoid postoperative recurrence. Under adequate hemostasis, the nerve is gradually exposed from the proximal to the distal end, and the palmar tendon membrane is excised while freeing it. However, it should be noted that due to the influence of the contracted tendon membrane, the finger nerve may deviate from its normal course or even cross the contracted tendon membrane, which should be avoided during surgery. Rebelo (1992) followed up 110 patients with palmar tenosynovial contracture treated surgically over a 10-year period, and 46.4% of them had recurrences, 74.1% of which occurred within 5 years after surgery. The postoperative recurrence rate of partial palmar tenotomy was 50%, and the postoperative recurrence rate of extensive palmar tenotomy was also high. Therefore, postoperative cases of palmar tenosynovial contracture should be reviewed on a long-term basis. The functional recovery can be assessed by Adam’s method, excellent: finger extension and flexion activities are completely normalized; good: finger flexion contracture is improved by more than 75%; moderate: finger flexion contracture is improved by less than 75%. Poor: no improvement in finger function. In summary, palmar tenosynovial contracture can be clinically typed according to the progress of the disease, and the Huang Shuolin typing method is more practical. The clinical treatment plan should be selected according to the different types. The timing of surgery should be taken early rather than late. Microsurgical excision of the palmar tendon membrane is the least traumatic and less likely to damage the vascular nerves, so it is recommended to promote its application. In view of the high recurrence rate of the disease, long-term postoperative follow-up should be performed, and recurrence should be treated promptly.