LAUSR

Dupuytren's diathesis describes an aggressive disease course with tendency for recurrence or extension following intervention. Conventional factors associated with Dupuytren's diathesis are ethnicity, family history, bilateral and ectopic disease. Disease recurrence is not the only cause of poor outcome following intervention. This systematic review aimed to identify all factors that have been investigated for a potential association with the development, progression, recurrence and outcome of treatment in Dupuytren's diathesis. A systematic review of MEDLINE, EMBASE and CINAHL using a PRISMA-compliant methodology up to February 2019 was conducted. Abstract screening and data extraction were performed in duplicate. Included prognostic cohort studies were quality assessed using the Quality in Prognosis Study tool. The search revealed 2,661 records from which 11 full text articles reported both conventional diathesis factors and outcomes (in addition to recurrence) following intervention for Dupuytren's in 938 patients. Collectively 67% underwent fasciectomy and seven outcomes were reported: three patient reported outcome measures (DASH, quick-DASH and EQ-5D), three functional measures (grip strength, joint angle correction and range of motion) and treatment complications. Two studies used multiple univariate statistical techniques and found no significant association between diathesis factors and disease outcome. This systematic review challenges conventional notions of Diathesis factors and provides a comprehensive appraisal of factors associated with poor outcome following intervention for Dupuytren's disease. Conventional factors associated with recurrence in Dupuytren's disease are not associated with poor outcome following intervention.