“…Suggestions for the development of recurrence in DD patients after surgery include incomplete excision of the palmar fascia, younger age, and a greater degree of diathesis, especially in those with Garrod's (knuckle) pads, indicating more active disease. 7,8 In addition to Hueston's 3 4 diathesis factors there are many environmental factors that have been associated with the cause of DD including a history of smoking, 9 alcohol consumption, 10 frozen shoulder, 11 epilepsy, 12 diabetes mellitus, 13,14 rheumatoid arthritis, 15 carpal tunnel syndrome, 16 history of manual labor, 17 and hand injury. 18 Other factors associated with increased severity include male gender and a young age at onset.…”