Dupuytren's contracture is the result of a pathological thickening of the superficial palmar fascia of the hand leading to an inability to straighten the finger, usually at the MP joint but sometimes at the PIP or even DIP joints. Although it is usually painless, it can interfere with function. The cause is unknown but there appears to be a genetic component (it is more prevalent in those of northern European heritage) and a loose association with alcoholism and epilepsy. It is sometimes confused with trigger finger, but it can be distinguished by the characteristic pits, nodules, and cords caused by the thickened fascia. The only generally accepted treatment at this time is surgical release of the diseased fascia. This can vary from simple percutaneous needle aponeurotomy under local anesthesia to more extensive resections sometimes requiring skin grafting. It is generally recommended that PIP contractures be corrected early due to the risk of permanent contracture from capsular tightness.