Dupuytren 's contracture (DC) is a disease of the palniar fascia resulting in thickening rind contracture of fibrous bands on the palmar sugace of the hands arid fingers. For decades, a controversy has e.xisted regarding whether acute traumatic injury or cumulative biomechanical work exposure can contribute to the development of this disorder. To address this controversy, this review considers the following questions: Is there e\idence that DC is associated Lcith I ) frequent or repetitive munual work; and 2) hand vibration ? The published literature M."S searched,for studies meeting the following criteria: I ) in English or having un Eiiglisli abstract; 2 ) controlled studies; 3) DC an identified health outcome studied; and 4 ) the study group exposed to repetitive or frequent manual work. vibration, or acute traumatic injuv. Relevant non-English articles identified through English abstructs were translated. The validity of studies meeting the selection criteria was assessed using a series qf questions adapted from those of Stock 11991: Am J Ind Med 19:87-1071. Studies that met a priori minimum levels of methodologic quality were taken into account to reach conclusions with respect to the above questions. Odds ratios (ORs) and 95% confidence intervals (CIS) were calculated fiw each study. Ten studies met the initial selection criteria. Of these, four studies met the criteria for methodologic quality, one addressing the relationship between manual work and DC, arid three studies of vibration arid DC. No controlled studies of acute trauma and DC were identified. Bennett 1196'2: Br J Ind Med 39:98-100].found the prevalence of DC at a British PVC bagging and packing plant in which workers were exposed to repetitive ntanual work to be 5.5 times that at CI local plant without packing, and twice the expected prevalence in a U. K. working population previously studied by Early [ 1962: J Bone Joint Surg 44B:602413]. DC was obsenved more frequently among vibration white finger claimants than controls by Thomas and Clarke [1992: