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What is a Contracture?

A contracture, also called a contracture deformity, is the lack of range of motion (ROM) in a joint due to structural changes in the muscles, tendons, ligaments, and/or skin excluding the bones. Symptoms include joint stiffness or the inability to move your joints freely. 
A contracture usually affects the shoulder, elbow, and knee joints. It can also affect the joint capsule, which is the dense, fibrous connective tissue present in the deeper layers of the joint that stabilizes your joint and adjoining bones.
Contractures may worsen with age if not treated properly. Eating a healthy diet, regular exercise, being active, and stretching helps prevent contractures.

What are the Causes of Contractures?

Contractures occur when the normal elastic connective tissues are replaced with rigid fibrous tissues. This could be due to various reasons such as:
  • Immobility post-fracture or surgery
  • Injuries such as burns or stroke
  • Chronic inflammation due to rheumatoid arthritis
  • Bone deformity such as scoliosis
  • Parkinson’s disease
  • Muscular dystrophy: a genetic disorder that leads to progressive damage and weakening of your muscles
  • Cerebral palsy: a neuromuscular disorder that impairs muscle movement and coordination
These factors alone or in combination can lead to the formation of contractures.
In children, contractures can occur due to juvenile idiopathic arthritis or juvenile rheumatoid arthritis, injury, trauma, fracture, congenital bone deformity, birth defect, lack of mobility or sedentary lifestyle, and juvenile Parkinson’s disease.

What are the Symptoms of Contractures?

Contractures cause difficulty in moving the joints. The symptoms typically include difficulty in common activities such as:
  • Straightening your fingers
  • Moving your hands
  • Stretching your legs
  • Extending your arm
Contractures may also lead to pain in the joints.

How are Contractures Diagnosed?

Contractures are diagnosed through a thorough physical examination. An X-ray may also be performed to view internal abnormalities. Your doctor will enquire about your medical history and family history to understand the cause of the contracture.

What are the Treatment Options for Contractures?

Contractures can be treated through a variety of methods that includes both a conservative approach and surgery. 

Non-Surgical Treatment

The first line of treatment for contractures is conservative management. This includes:
  • Medications to minimize pain and inflammation
  • Vitamin or calcium supplements to strengthen the bones
  • Immobilizing the joint using a cast or a splint to help stretch the tissues near the problem area
  • Physical therapy to increase mobility and muscle strength
  • Low-intensity exercise such as swimming to build muscle strength and bone strength
  • Walking aids
  • Occupational therapy to help children manage their symptoms during daily activities

Surgical Management

Surgery is recommended for severe contracture cases and those which do not respond well to conservative management. 
Surgery may involve any of the following:
  • Muscle lengthening
  • Bones, tendons, or ligament repair
  • Partial/complete joint replacement

Care and Recovery for Contractures

Following surgery, your surgeon will give you specific instructions to be followed to help in joint healing and recovery. 
A combination of a healthy diet rich in calcium and vitamin D, green leafy vegetables, fresh fruits, and physical therapy is recommended to improve bone and muscle strength and increase range of motion.
You must visit your doctor for periodic follow-ups to monitor your recovery for the best outcome.
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