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Causes and Types of Contractures

Contractures occur when muscles, tendons or ligaments around a joint shorten and stiffen, restricting the range of motion of the joint. They can be caused by injury, immobilization, nerve damage, muscle disease or chronic inflammation. Contractures are diagnosed through manual testing of joint mobility, measuring range of motion with a goniometer, or x-rays. Risk factors include rheumatoid arthritis, tendon inflammation, polio and other nerve/muscle diseases, trauma, burns or scarring. Treatment options include manual stretching, casting/splinting, continuous passive motion machines, and in severe cases, surgery. Early intervention through movement, physical therapy and splinting can help prevent contractures.

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359 views15 pages

Causes and Types of Contractures

Contractures occur when muscles, tendons or ligaments around a joint shorten and stiffen, restricting the range of motion of the joint. They can be caused by injury, immobilization, nerve damage, muscle disease or chronic inflammation. Contractures are diagnosed through manual testing of joint mobility, measuring range of motion with a goniometer, or x-rays. Risk factors include rheumatoid arthritis, tendon inflammation, polio and other nerve/muscle diseases, trauma, burns or scarring. Treatment options include manual stretching, casting/splinting, continuous passive motion machines, and in severe cases, surgery. Early intervention through movement, physical therapy and splinting can help prevent contractures.

Uploaded by

drhendyjunior
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Contracture

Hendy Buana Vijaya


Description
• Tissue contractures are commonly caused by the shortening or stiffening of
muscles and/or other connective tissues. When a contracture occurs in
muscles, tendons, or ligaments around a joint, the range of motion (ROM)
of the joint will be restricted.
• Can occur at any joint of the body. This joint dysfunction may be a result of
: immobilization from injury or disease nerve injury (spinal cord damage &
stroke) or muscle, tendon, or ligament disease.
Causes
Contractures may be caused by abnormalities of the structures surrounding a joint.
These include:
• Deformity
• Immobility Injury
• Chronic inflammation
• Certain disorders that affect nerves and muscles almost always lead to contractures.
For example: Muscular dystrophy, Cerebral palsy
• Contractures are often also associated with spasticity resulting from injuries to the
central
Diagnosis
• Manual testing of joint mobility
• Measuring the motion of the joint with a device termed a "goniometer“
• X rays
• physical examination involving physical and manual testing of the joint
motion
Mc Cauley classification
Risk
• A risk factor is something that increases your chances of getting a disease or
condition.
• Each of these conditions increases the risk for contractures:
a. Rheumatoid arthritis
b. Tenosynovitis (inflammation of a tendon and its sheath)
c. Polio and other diseases of nerves and muscles
d. Trauma ◦ Burns ◦ Scarring
e. Prolonged inactivity
Symptom
• The primary symptom is loss of motion in a joint.
• Pain can also be a major symptom
Treatment
Manual techniques
• Joint mobilization and stretching of soft tissues
Mechanical techniques
• continuous passive motion machines
• following surgery of joints.
• administered within the first 24-72 hours after the injury or surgery.
• The joint is mechanically moved through the patient's tolerable motion.
• CPM machines have been proved to accelerate the return motion process, allowing patients
more function in less time
Treatment
Casting or splinting
• used to provide a constant stretch to the soft tissues surrounding a joint.
• initial holding cast is applied for 7 to 10 days, a series of positional casts are applied at weekly
intervals.
Surgery
• manipulation of the joint under a general anesthesia
Alternative treatment
• Massage therapy can be beneficial by promoting additional circulation to joint structures, causing
better elasticity. Yoga can help prevent as well as rehabilitate a contracture and can facilitate the
return of joint mobility.
Hand splinting
Surgery

Fasciotomy Tendon repair


Flap Z dan flap interpolasi
Prevention
Prevention of contractures depends on the cause. After acute injuries or orthopedic surgery,
contractures may be prevented by:
• Early movement
• Physical therapy
• Continuous passive motion (CPM) machines, which mechanically keep joints in motion
• Aggressive medical treatment of inflammatory conditions such as rheumatoid arthritis may also
delay or prevent contractures
• program of positioning, splinting if appropriate, and range-of-motion exercises either manually
or mechanically aided.
These activities should be started as early as possible for optimal results
Prognosis
• Depend upon the cause of the contracture.
• In general, the earlier the treatment for the contracture begins, the better the
prognosis.

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