Management of severe Dupuytren’s contracture is challenging and is often associated with high complication rates as well as recurrence. External fixation devices can be applied to exert continuous extension torque, thereby gradually correcting the severe flexion contracture. A variety of devices, techniques, treatment durations, and indications for use exist, with no clear consensus. Often, treatment is initiated with preliminary external fixation for gradual extension correction, followed by traditional open fasciectomy. This staged management appears to provide superior outcomes in terms of contracture correction and recurrence compared to fasciectomy alone. However, robust long-term comparative studies are currently lacking.