What is Dupuytren’s Contracture?
Dupuytren’s contracture is a syndrome that causes the fingers to bend towards the palm. This happens because nodules – small tissue or fluid filled growths –form on the connective tissues, also known as fascia, under the skin. These are benign, meaning they are non-cancerous.
The nodules begin to grow and often develop into thickened, shortened string-like cords beneath the skin. As these cords continue to grow, they cause the fingers to start bending inwards. This contraction is what gives the condition its name. Up until the point when contraction occurs, the condition is simply known as Dupuytrens disease.
Many people experience no negative effects to speak of, especially in the earlier stages of the condition. It’s not painful and is often more of an inconvenience, rather than something that causes real suffering.
However, those with later stage Dupuytrens will experience a contraction of the fingers, they’ll bend towards the palm, creating difficulty holding things. Once the contraction of the fingers begins, it can become permanent and disabling.
It will more than likely prevent those with the condition from holding things tightly, potentially making everyday tasks, such as fastening buttons or tying shoe laces, difficult. It may also make working impossible. Understandably, this is the condition that attracts compensation payments. However, there are a number of criteria, detailed below, that must be in place before any claim can be made.
What Causes Dupuytren’s Contracture?
The truth is the doctors don’t really know. The British Dupuytrens Society advises that there are a number of factors that can affect the chances of you developing Dupuytren’s Contracture. These include:
- genetic traits
- certain illnesses, such as HIV, diabetes and heart disease
But, many of those with the condition have none of these risk factors, so the true origins of the condition remain a mystery.
New Research Offers Hope for Industrial Disease Compensation
However, a new factor is emerging as a possible cause in the development of Dupuytrens contracture, and that’s the one we’re concerned with here. In a report from the Industrial Injuries Advisory Council, they confirm that evidence points to working with tools that vibrate the hands and arms as a contributory factor. They state:
‘Any occupation involving the use of hand-held powered tools whose internal parts vibrate so as to transmit that vibration to the hand, but excluding those tools which are solely powered by hand, where the use of those tools amounts to a period or periods in aggregate of at least ten years and where, within that period or those periods, the use of those tools amounts to at least two hours per day for three or more days per week and where the onset of the disease fell within the period or periods of use specified in this paragraph.’
Dupuytren’s Contracture Diagnosis
Diagnosis is by simple palpation. This means your doctor will feel for the nodules and thickening of your ligaments using his fingers. He may also use the table test, which involves you placing your hand on the table palm down to establish how flat you can get your hand.
Dupuytren’s Contracture Treatment
The condition of bent fingers is easily treatable with surgery, should it progress to that stage. And, now there are treatments for the earlier stages too, which can prevent the condition from becoming serious in the first place. Some of these newer treatments may not be available on the NHS, but are available via private clinics in the UK and include the use of radiotherapy and collagenase injections.
The general stages of treatment:
Stage N and N1:
Stage N and N1 of the condition requires only minor treatment. The nodules and cords have only just started to develop and there’s little, or no, contracture. Often patients can help ease their condition using massage or exercises, which can keep the hands and fingers loose.
Radiotherapy is another promising treatment. However, it appears that it is only effective when the nodules are in their growth stage and it can cause some minor side-effects, such as dry skin. It also seems that it is not always effective in every case.
Steroid injection is another treatment option that’s been used with some success by doctors.
Stage 1 and 2:
As the condition progresses, a needle aponeurotomy can become an appropriate treatment. However, the contracted cord needs to be well away from any nerves of tendons in the hand.
Another effective treatment for this stage of the condition is to have collagenase injections. These injections will dissolve the tissue that makes up the cord, allowing the fingers to be straightened. This does come with a small risk though – there’s a chance that a tendon may be ruptured.
Stage 3 and 4:
Once the condition reaches stages three and four, the only real option is to have surgery. Usually, surgery will be recommended for those people who have a 40% bend in the joint nearest to the palm, also called the metacarpophalangeal or MCP point. Surgery is also recommended for those who have a 20% bend in the PIP joint, which is the second joint from the tip of the finger.
There are some other treatments in use, but they are not so common and there is some doubt about how useful they are. However, they are always worth a try, especially if there are few negative side-effects. These include ultrasound treatment, shockwave treatment and blue light treatment.
Dupuytren’s Contracture Claims & Compensation
Claims for Dupuytrens Contracture can only be started if the criteria stated above – ten years of working with hand-held vibrational tools, at two hours per day for at least three days per week – is met. Without this, there will be no possibility of compensation.
However, if you do meet the criteria and your life has been affected by being unable to use your fingers properly, you should make a claim for compensation. It’s designed to make your life easier and give you the financial help you’ll need if you are unable to work.
Am I Likely to be affected by Dupuytren’s Contracture?
It’s not that likely, but still possible, especially if you’ve worked with vibrational tools for more than ten years, for two hours per day for at least three days per week.
Remember, you cannot claim if your Dupuytrens Contratcure developed without the use of hand-held vibrational tools.
I Think I May Have Dupuytren’s Contracture, What Should I Do?
First of all, you should visit your GP. They will be able to diagnose the condition. You should talk to your GP about:
- Any past or present jobs that involve working with tools that vibrate the fingers and hands for extended periods of time.
- The symptoms experienced in response to movement or physical exercise.
- Tests you may need to determine the extent of the contracture.
- Whether you should see a specialist.
- How to protect yourself in the future.
Once there is a firm diagnosis, and you are certain that you meet the criteria for claims related to Dupuytren’s Contracture, you should contact us.
We’ll take down the details we need to advise you on how we can help you with your claim.
Dupuytren’s Contracture Help and Advice
If you have spoken to your GP and have received a Dupuytren’s Contratcure diagnosis, or if you suspect that you, or someone you know, may be affected by the condition, you should explore whether your condition may be due to your working conditions. If it is, you may be entitled to claim for compensation.
We pride ourselves on our provision of first-class legal advice and support. Our team of specialist Industrial Disease solicitors have a wealth of expertise, and knowledge, that you will be hard-pressed to find elsewhere. For free, expert advice on pursuing an industrial disease claim, speak to us today.
Our dedication to client care and quality service isn’t just great, it’s award winning! In fact, 95% of our clients would recommend us to a friend.