In this study of 38 patients, we assessed the clinical result following surgical treatment of Dupuytren's disease with isolated fifth ray involvement, particularly with respect to the proximal interphalangeal joint. Three surgical techniques were used: limited fasciectomy, segmental fasciectomy and dermofasciectomy. At a mean follow-up time of 53.6 months, there were no residual deformities nor recurrences in the metacarpophalangeal joint. At the proximal interphalangeal joint, there was an overall improvement of 45 degrees in movement with a residual flexion deformity avering 30 degrees. The recurrence rate in this series was 39%. There was no significant difference in residual deformity or recurrence rate between the various surgical techniques used. Fifth ray involvement in Dupuytren's disease remains a surgical challenge, especially at the proximal interphalangeal joint. Residual deformity and recurrence rate remain high, irrespective of the surgical technique used.