Aims: We present a prospective study, with three-year follow-up, of the role and outcome of fasciectomy plus surgical release of structures of the PIP joint in Dupuy-tren’s contracture of the fifth ray. Methods: All patients presenting for surgery with primary Dupuytren’s contracture of the fifth ray over a six-month period were included in the study. All underwent fasciectomy followed sequentially by release of the abductor band, accessory collateral and checkrein ligaments as necessary. Deformity and range of motion in the PIPJ were measured by goniometer preoperatively, intra-operatively (post-fasciectomy and post-PIP release) and at three months and three years postoperatively. Results: Of the nineteen fingers in the study, eight (all mild deformity) achieved a full correction by fasciectomy alone. 78% correction remained at three months and 70% at three years. The remaining eleven fingers (initial mean deformity 70o flexion) obtained only a 38% correction by fasciectomy, increased to 90% with PIPJ release. Of this correction 64% was maintained at three months and 57% at three years. These figures include one recurrence of Dupuytren’s and are comparable with those of other techniques. Conclusion: We conclude that sequential PIPJ release is a useful technique for the correction of severe Dupuytren’s of the fifth ray involving that joint.