Evidence Checklist: Dupuytren's Contracture

Hand surgery evaluation documenting Dupuytren's contracture severityCritical

Examination documenting palmar fascia cord palpability, affected finger(s), metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint contracture degrees, and the Tubiana staging. VA rates under limitation of motion of the affected digits.

Nexus opinion linking Dupuytren's contracture to service ("at least as likely as not")Critical

A medical opinion connecting your palmar fibromatosis to military service, including repetitive manual labor, vibrating tools, or trauma to the hand during service.

Finger range of motion measurements (flexion/extension for each affected digit)Critical

Goniometric measurements documenting the degree of fixed flexion contracture and any residual extension deficit at the MCP and PIP joints of each affected finger.

Documentation of dominant vs. non-dominant hand

Medical records specifying which hand is predominantly affected and which hand is dominant.

Treatment records (Xiaflex injection, needle aponeurotomy, fasciectomy)

Records documenting collagenase clostridium histolyticum (Xiaflex) injections, percutaneous needle fasciotomy, or surgical partial/total fasciectomy and outcomes.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Hand and Finger ConditionsCritical

Standardized form capturing finger range of motion, contracture degree, affected digits, and functional limitations.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.