As early as 1614, the Swiss Plater described in his book a condition called Dupuytren’s contracture of the palmar tendon. In 1777, Cline proposed a method of pathological band severance. Cooper was the first to perform a percutaneous fasciotomy and called it “Cooper’s fasciotomy”. Later, from Goyrand’s limited fasciotomy in the early 19th century to the total palmar tenotomy in the mid-20th century, surgeons gradually tended to selective fasciotomy or limited fasciotomy because of the high complications, but there were still problems such as surgical trauma and skin necrosis of the hand. In recent years, some surgeons have modified Cooper’s fasciotomy and called it percutaneous needle fasciotomy. Some foreign studies have reported good results. In this study, we investigated the recent efficacy and complications of the treatment of palmar tendon contracture by following up cases treated with percutaneous needle fasciotomy at our hospital since 2007. I. Choice of treatment Palmar tendon contracture is a painless progressive contracture deformity that cannot be cured, but with proper treatment, functional improvement can be obtained in most cases. The main goal of the patient’s visit is also to correct the hand deformity and restore the function of the hand as much as possible. The treatment of palmar tendon contracture is still mainly surgical. In the domestic literature, the treatment of palmar tendon contracture is mostly limited excision or extensive excision of the palmar tendon membrane by incision. Van Rijssen [7] compared the efficacy of percutaneous acupuncture fasciotomy with limited resection of the tendon, and the rates of improvement in limitation of movement were 63% and 79%, respectively, while the rates of serious complications were 0% and 5%, respectively, while the rates of total complications (including hematoma, skin necrosis, nerve injury, sympathetic dystrophy, etc.) of the latter were as high as 30%. up to 30%. None of these complications are desired by physicians or patients. A multicenter study reported in the foreign literature showed that the complications of percutaneous needle fasciotomy in 3736 fingers were only 2% skin laceration and 0.8% nerve injury, and although the 5-year recurrence rate of this method was about 50.4%, it was possible to treat the patient with the same surgical method even in case of recurrence because of less pain, faster recovery, and fewer complications. However, percutaneous needle fasciotomy can be a preferred method for the treatment of palmar tendon contracture. However, this method is not suitable for particularly severe cases, and its best indication is Tubiana grade I or II contracture. Prevention of complications Percutaneous needle fasciotomy is a blind release, so there is also a risk of accidental injury to the finger nerves and finger vascular bundles, and even cases of severed finger flexor tendons have been reported in the literature. To avoid or minimize this risk, (1) it is important to have a thorough understanding of the pathologic anatomic structure and contracture characteristics of palmar tendon contractures. The release of contracture at the spiral bundle site is most likely to injure the vascular nerve bundle. Watson has well described the characteristics of contracture at the spiral bundle site in the literature, and if a positive Watson test is found preoperatively, we can avoid this site and cut the contracture bundle at its proximal end, thus avoiding injury to the vascular nerve bundle here. (2) Intraoperative caution should be exercised so that the needle tip does not penetrate too deeply and injure the deep tendons. (3) In cases of flexion contracture >90°, skin lacerations are very likely to occur during transcutaneous fasciotomy and release, especially in areas where the skin is tightly adherent to the fascia, and the way to prevent this is to first use the needle tip to release the skin between the skin and the fascia, free the locally adherent skin, and then cut the fascia to straighten the joint. If the proximal fascia is cut first, sometimes the distal fascia cannot be touched and cannot be cut, resulting in recurrence soon after surgery. In conclusion, percutaneous acupuncture fasciotomy is a relatively simple, less invasive, less complicated, and reliable method of treating palmar tendon contracture. A good grasp of the indications and surgical techniques can achieve good results and avoid complications.