Concierge hand surgery · London
Private percutaneous needle fasciotomy in London, for Dupuytren’s — quick, low-morbidity, day case.
A same-day, low-morbidity option for palmar Dupuytren’s cords — done under local anaesthetic by a consultant hand surgeon, with hand therapy included in the package.
Why patients choose us
- 01
Consultant hand surgeon, every time
BSSH-accredited hand surgeons with a high-volume Dupuytren’s practice — not a generalist doing the odd cord.
- 02
Hand therapy comes with the procedure
A needle fasciotomy without a therapy plan wastes the window. We pair the procedure with a dedicated hand therapist from day one.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private needle fasciotomy costs in London.
Indicative ranges across our partner hand surgeons. Send the details and we quote firm figures across two or three options.
In short
A single-cord PNF in our network: £1,200–£2,500, done in 20–30 minutes under local anaesthetic.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| PNF — single cord (single finger) | £1,200–£2,500 | 20–30 min | Same visit |
| PNF — multiple cords (single hand) | £1,800–£3,500 | 45 min | Same visit |
| PNF — both hands | £2,800–£5,000 | Half-day | Same visit |
| PNF + hand therapy bundle | £1,700–£3,200 | Half-day | Same visit |
| Post-PNF splinting review | £180–£350 | 20 min | Same visit |
| Consultation only | £200–£400 | 30 min | Same visit |
Prices vary by surgeon, by the number of cords released, by whether one or both hands are treated, and by whether hand therapy is bundled. We come back with a firm quote within one working day.
The problem
You don’t always need open surgery for a Dupuytren’s cord.
For a discrete palmar cord causing MCP joint contracture, a percutaneous needle release under local anaesthetic gives immediate correction and a same-day recovery — with much less morbidity than open fasciectomy.
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Worried the finger won’t straighten?
Most MCP contractures correct substantially in the room. PIP is harder — the surgeon will be honest about what to expect.
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Nervous about a general anaesthetic?
PNF is done under local anaesthetic only. No sedation, no fasting, home the same hour.
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Been told the cord will come back?
Recurrence is more common than after open surgery — the trade-off for a small, repeatable, day-case procedure.
The journey
From enquiry to hand therapy — what happens, in order.
One clinician from first message to review — including the splinting and hand-therapy plan in between.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
~1 hour at the clinic
Phase 3 · After
Splinting + therapy
- 01
Before
You tell us about the cord
A short, confidential form. Which fingers, how long, any prior fasciectomy or collagenase, and any medication — especially blood thinners.
- 02
Before
We come back with a recommendation
Within one working day: whether PNF is suitable, which consultant hand surgeon, indicative price. If open fasciectomy is the better call, we say so.
- 03
Before
We arrange the appointment
Usually within a week. We review your medication and confirm the splinting and hand-therapy pathway before you attend.
- 04
On the day
Arrival at the clinic
Arrival and consent. The palm is cleaned and infiltrated with local anaesthetic along the cord — the only sharp moment.
- 05
On the day
The needle fasciotomy
20–45 minutes. You are awake and comfortable. The surgeon uses the bevel of a fine needle to divide the cord at several levels, then extends the finger.
- 06
On the day
Home the same day
A soft dressing, extension check, and home within the hour. Driving is fine unless the dominant hand was treated.
- 07
After
Splinting and hand therapy
Overnight extension splint for a few weeks, hand therapy starting within days, and a review to check correction and plan any next steps.
Typical end-to-end: 1–2 weeks to procedure, then 4–6 weeks of splinting and therapy before review.
When it helps
When needle fasciotomy is the right next step.
Not every Dupuytren’s cord suits a percutaneous release. These are the situations where PNF, alongside splinting and hand therapy, tends to earn its keep.
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MCP joint contracture
MCP-predominant Dupuytren’s cords respond very well to PNF, with high early correction rates.
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PIP joint contracture (harder)
PIP contracture is harder to fully correct with a needle — expect partial correction and plan therapy accordingly.
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Palpable cord
A discrete, palpable cord in the palm or finger is the ideal target for percutaneous release.
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Table-top test positive
If you can’t lay your hand flat on a table, a needle fasciotomy is a reasonable first-line option.
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Recurrence after prior surgery
Recurrent cord after prior fasciectomy can sometimes be released with a needle — the surgeon will judge on the day.
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Diabetic patient (careful post-op)
Diabetes doesn’t rule out PNF, but wound healing and hand therapy need closer follow-up.
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Elderly patient
Well tolerated in older patients — local anaesthetic only, no general anaesthetic, home the same day.
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Red flag: acute cord rupture during procedure
A skin tear or cord rupture during release needs an on-the-day hand surgeon plan — not a walk-in clinic.
Procedure types
Not every PNF is the same.
What each option on your referral is actually for.
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Single-cord PNF
One cord, one finger — the classic PNF, done under local anaesthetic in the outpatient setting.
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Multi-cord PNF
Several cords in the same hand released in one visit — longer session, same recovery.
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Bilateral PNF
Both hands treated in a half-day list, where the cords are suitable and you can manage post-op splinting on both sides.
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PNF + hand therapy bundle
The procedure plus a set number of hand-therapy sessions bundled into one price.
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PNF + splinting programme
The procedure plus a custom overnight extension splint and review appointments.
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PNF + collagenase (hybrid)
For selected cases where a needle release is combined with collagenase for the deeper element of the cord.
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Post-op review only
A splint check and extension review after a PNF done elsewhere.
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Consultation
A consultant hand surgeon opinion on whether PNF, collagenase or open fasciectomy is right for you.
Our vetted London network
A small panel of hand surgeons, we picked them.
BSSH-accredited consultant hand surgeons across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every hand surgeon in our network.
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BSSH-accredited consultant hand surgeons
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High-volume Dupuytren’s practice — cords weekly, not occasionally
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Combined hand-therapy pathway built into the package
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Onward fasciectomy pathway if PNF is unsuitable or the cord recurs
Safety and eligibility
Safer, and simpler, than most people expect.
Percutaneous needle fasciotomy is safe and usually straightforward. The things worth planning are blood-thinning medication, the extent of your PIP contracture, and prior treatment on the same hand.
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Local anaesthetic only
No sedation, no general anaesthetic — you are awake and eat normally beforehand.
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Brief tingling from nerve proximity
A short-lived tingle in the finger during infiltration is common — the surgeon adjusts the needle if it persists.
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Small skin nick, no formal wound
The needle leaves a tiny puncture rather than a surgical wound — no stitches in most cases.
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Finger extension check at the end
The surgeon extends the finger at the end of the procedure to confirm correction before you leave.
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Higher recurrence than open surgery
PNF has a higher recurrence rate than open fasciectomy — an accepted trade-off for the much smaller procedure.
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Not for advanced PIP contracture
Severe, longstanding PIP joint contracture usually needs open fasciectomy rather than a needle release.
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Not for post-fasciectomy recurrence usually
Recurrence after prior open surgery is often better managed with revision fasciectomy — the surgeon will advise.
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Post-procedure splinting overnight
A custom overnight extension splint for several weeks helps hold the correction and protect the release.
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Driving after is fine unless dominant hand
Most people drive home unless the dominant hand was treated — in which case arrange a lift for that day.
Reading your report
A PNF report is short. Read the last part first.
Whichever cord was released, the report keeps to the same four parts.
A quiet reminder
The release is only the start — the splint and hand therapy are what hold the correction.
If you would like us to talk you through it before your therapy starts, just ask.
- 01 Header
Contracture severity and prior treatment
Which fingers, MCP and PIP contracture in degrees, and any prior fasciectomy, collagenase or PNF on that hand.
- 02 Technique
Cord and level released
Which cord was targeted (pretendinous, spiral, central, natatory), the levels released, and the local anaesthetic used.
- 03 Findings
Post-release correction
The extension achieved at MCP and PIP after release, and any residual cord or skin tethering noted on the day.
- 04 Impression
Outcome, splint plan, hand-therapy timing
Read this first. The result of the release, the splinting programme, when hand therapy starts, and when to review.
Recognised by major UK insurers
Most policies cover Dupuytren’s procedures when clinically indicated; we confirm cover and pre-authorisation before booking.
Frequently asked
Everything we get asked about needle fasciotomy.
Quick answers on pain, recovery, recurrence, PNF vs collagenase, PNF vs open surgery, and cost.
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What is a percutaneous needle fasciotomy?
A minimally-invasive treatment for Dupuytren’s contracture in which a consultant hand surgeon uses the bevel of a fine needle to divide the diseased cord under local anaesthetic. The finger is then extended to correct the deformity. There is no formal wound — just a small skin nick — and you go home the same day.
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Does needle fasciotomy hurt?
Less than most people expect. The palm and cord are infiltrated with local anaesthetic first, so the release itself is felt as pressure. A brief tingle in the finger during infiltration is common if the needle sits close to a nerve — the surgeon adjusts and moves on.
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How long is recovery after PNF?
Most people use the hand for light tasks the same day and are back to normal activities within a week or two. Heavy grip and manual work is best deferred for a couple of weeks. Overnight splinting continues for several weeks to hold the correction.
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Can I drive after needle fasciotomy?
Usually yes, unless the dominant hand was treated — in that case arrange a lift for the day of the procedure. The following day most people drive normally.
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What is the recurrence rate after PNF?
PNF has a higher recurrence rate than open fasciectomy — a substantial proportion of patients see the cord return within a few years. It is an accepted trade-off for a much smaller, quicker, day-case procedure that can be repeated if needed.
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PNF vs collagenase — which is better?
Both are minimally-invasive alternatives to open surgery, with similar short-term correction. PNF is a same-visit procedure with immediate release. Collagenase involves an injection and a return visit for finger manipulation, and can carry more skin bruising. Your surgeon will advise based on the cord type and your preferences.
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PNF vs open fasciectomy — which is better?
Open fasciectomy gives more durable correction — especially for PIP joint contracture and complex cords — but involves a formal wound, a longer recovery and hand therapy over weeks. PNF is quicker and less invasive, with more recurrence. Neither is universally "better" — the right choice depends on the cord and the finger.
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Does PNF work for PIP joint disease?
PIP joint contracture is harder to fully correct with a needle than MCP contracture. Partial correction is the honest expectation. Severe, longstanding PIP contracture is usually better treated with open fasciectomy.
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How much does needle fasciotomy cost privately in London?
A single-cord PNF is typically £1,200–£2,500. Multiple cords in one hand £1,800–£3,500. Bilateral PNF £2,800–£5,000. A PNF + hand therapy bundle £1,700–£3,200. We confirm a firm figure within one working day.
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When should I see a hand surgeon urgently?
A rapidly progressing contracture, a cord that becomes painful, or a skin tear over a cord all warrant a hand surgeon opinion promptly rather than routine referral. If you have already had PNF and the finger will no longer extend, or the wound looks infected, ask to be seen the same week.
Related
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Dupuytren’s contracture
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