Dupuytren’s contracture : Mnemonics

Associations of Dupuytren’s Contracture

Mnemonic: DEAFEST LIAR

1. Diabetes mellitus
2. Epilepsy
3. Age (positive correlation)
4. Family history (autosomal dominant)/Fibromatoses
5. Epileptic medications (phenobarbitone)
6. Smoking
7. Trauma and heavy manual labour
8. Liver disease (Alcoholic)
9. Idiopathic (most common)
10. AIDS
11. Reidel’s thyroidits

Dupuytren’s diathesis

Mnemonic: ABCDEF

Severity and recurrence risk is increased in:

1. Age at onset <50 years
2. Bilateral palmar lesions
3. Country (North European)
4. Dude (Male)
5. Ectopic lesions (Garrod’s pad, Peyronie’s disease, Ledderhose’s disease)
   • Ledderhose disease (plantar fascia): 10-30% association
   • Peyronie’s disease (dartos fascia of penis): 2-8% association
   • Garrod disease (knuckle pads): 40-50% association
6. Family history

If all 6 diathesis risk factors are present: risk of recurrence is 71%

If none of diathesis risk factors are present: risk of recurrence is 23%

Involvement of fingers

Mnemonic: RaSMIT

In order of decreasing frequency:

1. Ring
2. Small
3. Middle
4. Index
5. Thumb

30-20-10 rule for Surgery in Dupuytren’s contracture

Surgery should be considered when:

1. MCP joint contracture >30 degrees
2. PIP joint contracture >20 degrees

Recurrence following surgery is <10% at 10 years