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Understanding Contracture Deformity: Tightened Muscles

What is contracture deformity?

A contracture deformity refers to a shortening of a muscle, tendon, ligament or skin that prevents normal movement. It results from a decrease in flexibility of normally pliable connective tissues, limiting the range of motion. A person may experience difficulty moving a limb, straightening fingers or extending another part of the body. The normal elastic tissues are replaced by non-stretchy (inelastic) fibre-like tissue, which prevents movement.

Contractures can occur in different parts of the body. A muscle contracture causes shortening or tightening of muscles, while a joint contracture will limit the range of motion in the area of the body where the bones meet. Sometimes, the condition may also cause scarring and contraction of the skin, further inhibiting movement.

What are the causes of the disorder?

The main causes of a contracture are hypertonic spasticity scarring that results from an injury or burn. Also, people with other conditions that limit their movement are at high risk of having their muscles and joints tightened. For example, joint contractures are common in patients who are discharged after long hospital stays.

Other causes of contracture deformity may include inherited diseases or conditions that develop in early childhood. For example, muscular dystrophy causes weakness and loss of muscle tissue, and people with this condition often experience muscle tightness. Cerebral palsy also causes muscle tightness, limiting movement. Other diseases that can cause this condition include polio and rheumatoid arthritis.

What one needs to know about symptoms or signs?

The muscle, tendon, ligament or skin tightens and normal movement of the associated body part is inhibited. The skin may appear scarred or inelastic, like after an injury or severe burn.

Which specialist should be consulted in case of signs and symptoms?

Persons experiencing signs of contracture deformity like a decreased ability to move a joint must consult an orthopaedic surgeon.

What are the screening tests and investigations done to confirm or rule out the disorder?

Depending on the type and cause of the contracture, a patient may need diagnostic testing like an x-ray. The doctor will ask the patient about his/her medical history and will determine the specific location of the problem, intensity, range of movement.

What treatment modalities are available for management of the disorder?

Treatment options for contracture deformity include:

  1. Physical therapy – Physical therapy is a common form of treatment for contractures. The sessions help patients to increase the range of motion and strengthen the muscles. The exercises can also be performed at home.
  2. Support devices – The patient may be required to wear a cast or splint to allow the tissues of the affected area to stretch. Those with highly reduced mobility may need a wheelchair. A continuous passive motion (CPM) machine can help keep the affect part of the body moving.
  3. Medication – Anti-inflammatory medication can help reduce inflammation and pain. Patients of cerebral palsy are often given a botulinium toxin into their muscles as a way to delay surgery.
  4. Surgery – Surgery may be required to repair ligaments or lengthen muscles, tendons or bones damaged in an accident. For example, repairing a knee ligament can improve the range of motion in that joint over the long-term.

What are the known complications in management of the disorder?

Delaying treatment can make it difficult or impossible to completely regain range of motion in the affected area. Also, the condition limits the ability to perform every day tasks at home and work. It is important for a patient under long-term hospital care to tell their doctor about any stiffness or loss of movement they experience.

What precautions or steps are necessary to stay healthy and happy during the treatment?

Muscle and joint stiffness can be prevented through regular exercise and an active lifestyle. Those playing active sports must exert caution to prevent injuries. Any injury must be given immediate medical attention. Physical therapy and support devices that allow passive movement of the affected area prevent further stiffening.

How can the disorder be prevented from happening or recurring?

It is important that people seek timely treatment for chronic diseases and underlying conditions like rheumatoid arthritis to decrease and prevent symptoms.

 

Sources:

“Contracture deformity,” MedlinePlus, NLM, NIH, http://www.nlm.nih.gov/medlineplus/ency/article/003185.htm

“Contracture deformity,” Scripps.org, http://www.scripps.org/articles/1323-contracture-deformity

“Contracture Deformity,” Healthline.com, Chitra Bahdi, http://www.healthline.com/symptom/muscle-contracture

Image courtesy: Physio-pedia.com

 

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