van Rijssen 2006.

Methods	Single‐centre Dutch study Randomised controlled trial Recruitment between August 2002 and January 2005
Participants	125 hands in 121 participants 94 male:19 female; 8 incomplete Mean age: 63 years Inclusion criteria: yes: "(1) a flexion contracture of at least 30° in the MCP, PIP, or DIP joints; (2) a clearly defined pathologic cord in the palmar fascia; and (3) willingness to participate in this trial" Exclusion criteria: yes: "(1) patients with postsurgical recurrence or extension of the disease, (2) patients who were not allowed to stop taking their anticoagulants, (3) patients generally unfit to have surgery, and (4) patients who were not willing to participate in this study or had a specific treatment wish"
Interventions	Percutaneous needle fasciotomy vs Limited fasciectomy
Outcomes	Total passive extension deficit at MCPJ, PIPJ and DIPJ (presented as % change and converted in Tubiana stage): preoperative, 1 week, 6 weeks No differences between procedures for Tubiana I and II contractures by 6 weeks; fasciectomy superior for Tubiana III and IV contractures by 6 weeks Flexion deficit (distal palmar crease ‐ fingertip pulp): preoperative, 1 week, 6 weeks Data described but no comparative statistical analysis presented DASH PROM: preoperative, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks No significant differences between procedures before surgery; significantly lower DASH scores for needle fasciotomy at all time points after surgery Patient satisfaction: 6 weeks Angles measured by the surgeon; DASH and satisfaction reported by participants Significantly better after needle fasciotomy Complications described? yes Details: infection, haematoma, wound slough, skin fissure, sympathetic dystrophy, paraesthesia (defined as subjective tingling sensation without objective evidence of altered sensation), altered sensation, digital nerve injury, tendon injury, revision surgery
Notes	Length of follow‐up: 6 weeks Low‐quality evidence due to risk of bias and imprecision No sources of funding acknowledged; no conflicts of interest declared
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation via sealed sequential envelopes
Allocation concealment (selection bias)	Unclear risk	Sealed sequential envelopes but unclear whether opaque
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Loss to follow‐up not different between groups
Selective reporting (reporting bias)	Low risk	All data reported
Other bias	Low risk	No blocked randomisation in an unblinded study
Blinding of participants and personnel (performance bias) All outcomes	High risk	No blinding
Blinding of outcome assessment (detection bias) All outcomes	High risk	No blinding