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Dupuytren’s Contracture

Osterhout Berger Daley > Disabling Conditions > Dupuytren’s Contracture

Those who have trouble straightening their ring finger and pinky finger could have Dupuytren’s contracture. This condition causes a limited range of motion in one or both hands. This complication can result in an inability to perform work tasks. If the condition is severe enough to prohibit them from working, individuals suffering from the condition can apply for Social Security disability insurance. There are requirements that must be met in order to be granted benefits. Understanding how the condition progresses and the symptoms behind it can help individuals prepare for the application process.

What is Dupuytren’s contracture?

Dupuytren’s contracture, also known as palmar fascia, is a condition that causes deformities on the hand. Essentially, the elastic tissue (the fascia) thickens and tightens abnormally under the skin of the palm and fingers. The fascia is like a cord that runs from the palm of the hand to the fingers. When the fascia thickens, it draws the fingers down into the palm causing a limited range of movement and deformities. It usually affects the middle, ring, and small fingers. This can complicate simple daily activities like shaking someone’s hand, placing hands in pockets, putting on gloves, typing on a keyboard, preparing food, and more.

This condition seems to be more common in men than women, but it starts showing up in those who are more than 40 years old. There also seems to be a connection between those who have it being of northern European descent. Aside from the condition being connected to family history, there doesn’t seem to be a direct cause of the condition. Doctors have ruled out hand injury or occupational factors as being a cause. There do, however, seem to be risk factors that increase people’s chances of developing this condition. These include drinking alcohol, smoking, seizures, and diabetes.

Symptoms of Dupuytren’s contracture

This condition progresses slowly, but can first make an appearance as thickening of the skin under the palm. As it progresses, the skin can appear puckered or dimpled. A firm lump will appear on the palm next. This lump shouldn’t be painful, but it may be sensitive to the touch. As the condition progresses, the connective tissue will form cords that extend from the palm to the fingers. Once these cords tighten, the fingers will start to bend towards the palm. The tightened cords affect hand function and make it difficult to straighten the affected fingers. These symptoms will typically appear on the right hand first and may duplicate on the left hand. Symptoms can range from mild to severe, so it’s important that individuals keep an eye on the progression.

When the condition first makes an appearance, it may be difficult to diagnose so doctors may ask a lot of questions to rule out any arthritis. As it progresses and starts to take on its unusual shape, doctors will have a much easier time diagnosing the condition properly. Doctors will feel the hand and compare the affected hand to the unaffected hand. Once the condition has made its ways to the fingers, doctors may also try to flatten the affected hand against a table. The inability to lay affected hands flat against a flat, solid surface is a good indication that the individual has Dupuytren’s disease. Additional tests may be done to determine how far the condition has progressed. These include seeing how well individuals can grasp or pinch items with the affected hands, how much feeling is left in the thumbs and fingers, and testing the hand’s range of motion.

Treatment of Dupuytren’s contracture

Once someone is diagnosed with Dupuytren’s contracture, doctors will discuss treatment options. While there isn’t currently a cure for this condition, there are several options to treat the condition depending on how far it’s progressed. Some doctors may even suggest waiting until the condition is far along before recommending treatment. If this is the case, it’s important that individuals record the progress of the condition by conducting the “table-top” test and taking pictures. The “table-top” test just requires the individual to lay their affected hand on a flat surface and see how close they can get their hand to laying flat on top of the table.

If doctors do recommend getting treatment, there are several non-surgical and surgical options.

  • Non-surgical treatments
    • Medication: Most of the medication that’s available includes injections of some sort. Doctors may choose to inject enzymes, called collagenase, directly into the cord the weaken it and soften its tightness. Once the cord soften enough, the doctor will move the affected hand around in an attempt to break the cord altogether. If there’s pain, doctors may inject a corticosteroid that helps reduce swelling and inflammation. Steroid injections have also been known to slow the progression of this condition.
    • Needling: This treatment involves sticking needles through the skin to puncture and break up the cord. While this option can help provide temporary relief, the cords can come back.
  • Surgical treatments
    • FasciotomyThis procedure requires the doctor to make an incision in the palm and break up the cord. The difference between this surgery and needling is that needling is limited to the areas of the finger(s) that aren’t affected by nerves or tendons. The surgery allows doctors to see where these areas are and work on them carefully so that they don’t cause any permanent damage.
    • Subtotal palmar fasciectomy: For this procedure, doctors will also make an incision to remove the cord. However, this surgery requires a bigger type of incision. This is because this treatment actually removes the tissue rather than just breaking it up.

If surgery is required as a treatment, physical therapy may also be required during recovery. Once again, there isn’t a cure for this condition so it’s possible that the tissue could thicken again.

Social Security disability insurance (SSDI) for Dupuytren’s contracture

If symptoms from this condition are severe enough to impede on an individual’s ability to perform work tasks, the individual may be eligible for SSDI benefits. In order to qualify, individuals must meet certain requirements. The applicant needs to prove that they’re currently not working a substantial amount of time and making less than $1,220 per month. The applicant must also prove that the condition has or will affect them from working or earning more than $1,220 per month for 12 consecutive months.

The Social Security Administration (SSA) may also require that applicants complete a residual functional capacity (RFC) assessment. The SSA will perform this assessment to see what type of work the applicant is able to do. They’ll apply a function label to the amount of work the applicant is able to perform. The labels are sedentary, light, medium, or heavy. The SSA will review the applicant’s medical records in addition to the assessment. The SSA needs to see that the applicant is not only unable to perform the job they currently have, but is also unable to perform any other jobs.

How we can help

The application process is arduous and, unfortunately, many applicants get denied during their first submission. It’s possible to appeal a denial, but most people are too deflated to go through the process again. This is why it’s important to go through the process with an experienced disability lawyer from the start. Our experienced disability lawyers at Osterhout Berger Daley are experts in this field and know exactly what it takes to compile all the proper paperwork and submit the application properly the first time around.

There are several ways in which the team at Osterhout Berger Daley can help you receive the benefit you deserve. We help individuals who need to…

If you are facing one of these situations, please do not hesitate in reaching out. Our team of experienced attorneys are here to help, and your consultation is free.

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