The goals of open fasciectomy for Dupuytren’s disease are primarily to improve functional use of the hand by addressing contractures, avoiding recurrence, and the need for re-operation, and minimizing the rate of complications, both minor and severe. Improving functional use of the hand involves improving contractures at the metacarpophalangeal (MCP) and proximal interphalangeal joint (PIP). Patients present with total passive extension deficits as a result of contractures that should be evaluated as a total across all joints and on a joint-by-joint basis. Patients undergoing open fasciectomy should be counselled on the likelihood of residual deformity and expectations based on the significance of the contracture deformity they currently endure. Rate of recurrence and further disease extension as well as the technique-specific complications should be discussed with patients.