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At least 559 records · Page 31Linked to original sources
PubMed2000

[Transposition of expanded cervical-shoulder skin flaps for the repair of cicatricial contracture deformity of neck].

OBJECTIVE: To evaluate the efficacy of expanded cervical-shoulder skin flap in the treatment of cicatricial contracture deformity of neck, and improve the method for the repair of soft tissue defect of neck. METHOD: 12 patients with cicatricial contracture of neck were treated by pre-expanded cervical-shoulder skin flap and then transposition for the reconstruction of the defect after cervical scar resection. RESULT: All the 24 flaps were survived. Postoperative follow-up for 6 months to one year showed that the cervico-mandibular function and the external appearance of the flaps were satisfactory without swelling and contracture. CONCLUSION: Pre-expanded cervical-shoulder skin flap is available for the treatment of cicatricial contracture deformity of neck.

Adolescent↗
PubMed1992

Contractures after burns: some observations from a 3-year review in Zimbabwe.

A retrospective study is presented of 53 consecutive patients (25 men, 28 women) with contractures following burns admitted to Mpilo Central Hospital between August 1988 and August 1991. Of the total, 85% were aged 12 years or less. Most of the patients (75%) came from rural areas and in 67% of cases where the nature of the burning agent was known, the burn resulted from an open fire. The site most commonly affected was the hand (51% of cases). Most of the contractures were released either by cross cutting and split skin grafting, or by using some form of flap. No major complications were encountered apart from a few minor wound infections which settled down on antibiotics and dressings. To reduce the incidence of contractures in our practice it is important to educate the rural community about the dangers of open fires especially to children. Rural health personnel should be encouraged to consider early referral of patients with burns likely to lead to contracture formation.

Adolescent↗
PubMed1992

Contractures in neuromuscular disease.

The percentage of subjects with contractures, mean maximal loss of range, and relative contracture indices are reported in 230 patients, with 11 diseases seen in a neuromuscular disease clinic during a five-year period. The highest percentage of contractures occurred in patients with Duchenne muscular dystrophy. The number of contractures was significantly greater (p less than .001) (1) in the lower than in the upper extremities; (2) in diseases considered myopathic than in those considered neuropathic; (3) in diseases that are X-linked than in those that are not; and (4) in rapidly progressive than in slowly progressive diseases.

Adolescent↗
PubMed2004

[Management of severe postburn scar contracture in the lower extremities].

OBJECTIVE: To summarize the clinical experience in the management of severe postburn scar contracture in the lower extremities. METHODS: The scars in popliteal fossa and ankle joint were excised. Traction and skin grafting were employed in the management of contracture deformity in these areas. RESULTS: Severe postburn scar contracture deformity in sixty postburn patients could be corrected by constant traction and skin grafting. CONCLUSION: Scar excision and lysis with constant traction might be an optimal method in the management of severe postburn scar contracture deformity of joints in the lower extremities and satisfactory results could be obtained without tendon grafting and elongation.

Adolescent↗
PubMed2006

[Expanded clavipectoral skin flap combined with reverse axis skin flap in repairing cervical scar contracture deformity after burn].

OBJECTIVE: To evaluate the effect of a combined cervical expanded skin flap in repairing cervical scar contracture deformity after burn injury. METHODS: From April 2001 to May 2003, 16 cases (10 males and 6 females) of scar contracture deformity in the cervix were treated with expanded clavipectoral axis skin flap combined with reverse axis skin flap. The tissue expanders were embedded under the part containing cutaneous branches of transverse cervical artery in cervical segments and the second and/or the third perforating branch of internal thoracic artery for the first operation. Normal saline was injected regularly. The expanded clavipectoral skin flap and reverse axis skin flap with perforating branch of internal thoracic artery were designed, the scar in the cervix was loosed or dissected according to the size of the skin flaps, the skin flaps were transferred to cover the wound, and the contracture deformity in the cervix was corrected. The size of the flaps were 9 cm x 5 cm-15 cm x 7 cm. RESULTS: All skin flap survived. The function and appearance of the cervix was improved significantly after 6-30 months follow-up. However, venous return dysfunction in reverse perforating branch of internal thoracic artery occurred in 1 case, and blood circulation was improved after treatment. CONCLUSION: Expanded clavipectoral axis skin flap combined with reverse axis skin flap can be used to repair scar contracture deformity in cervix, which lessen scar and abate the chance to contract again.

Adolescent↗
PubMed1991

The myofibroblast in Dupuytren's contracture.

Dupuytren's contracture nodules, but not cords, contain myofibroblasts. These cells, which combine many electron microscopic, physiologic, and immunohistochemical characteristics of fibroblasts and smooth muscle cells, are probably the active force of contraction. Prominent myofibroblasts and intracellular microtubules correlate with increased likelihood of clinical recurrence after surgery. Tissue culture of cells derived from Dupuytren's contracture myofibroblasts show consistently slower cell replication than from fibroblasts and show persistence of electron microscopic characteristics in early passages. Research in Dupuytren's contracture myofibroblasts has been done on human tissue and so has clinical correlation. Myofibroblast presence may help to predict recurrence of disease and suggests that palmar skin should be excised when adherent to disease nodules. The theory of myofibroblasts helps explain why the open technique often succeeds, and why full thickness skin grafts inhibit recurrent contracture.

Dupuytren Contracture↗
PubMed1976

[Angiopasm and lesion of the ulnar nerve in Dupuytren's contracture (author's transl)].

30 patients with Dupuytren's contracture were investigated by venous occlusion plethysmography of the index and ring fingers of both hands. The results are evaluated in respect to the clinical and electroneurophysiological findings. Special attention was given to the blood flow disturbances which have plethysmographically appeared to be a significant feature of Dupuytren's contracture and also to ulnar nerve lesions in individual cases. The finger venous occlusion plethysmography technique of Goetz (1934) has been further developed and a suitable apparatus constructed for the purpose of these investigations. Temporary vasopasm occurs in 77% of the patients suffering from Dupuytren's contracture when the fingers are cooled to 15 degrees C and a significant diminution of blood flow, as in the Raynaud syndrome, is evident. These neurovascular changes always appeared on the fingers of both hands and were similarly found in the region of the median nerve and of the ulnar nerve. They did not depend on the localization or the stage of the disease. 68% of the patients had symptoms suggestive of an ulnar nerve lesion, which corresponds with the findings of Mumenthaler (1961). In a comparison of the patients with normal plethysmographical findings and the patients with vasospasm, there is no correlation with the accompanying ulnar lesion. It is, thus, suggested that temporary vasopasm is not a consequence of the ulnar nerve lesion, but is related to an independent constitutional factor. In view of the high incidence of the ulnar lesion in patients with Dupuytren's contracture, a special neurological investigation is recommended and appropriate therapy, in addition to the fasiectomy, must be undertaken.

Adult↗
PubMed1991

[Use of the Volkov-Oganesjan distraction-reposition apparatus in treatment of flexion contractures of the interphalangeal joints].

In the submitted paper the authors present their experience with the treatment of flexion contractures by a Volkov-Oganesjan distraction reposition apparatus. The principle of treatment is continuous distension of shortened ligaments. The Volkov-Oganesjan apparatus makes systematic rehabilitation of the joint possible during gradual reposition of the contracture and at the same time prevents damage of the articular cartilage. The group comprised six patients who were treated and followed up. In four a post-traumatic condition was involved, once burns caused by electric current, and in one patient reoperation of a flexion contracture was involved. The mean grade of fixation of the PP joint before operation was 70 degrees. On average correction to 22 degrees was achieved. The mean period of treatment with the apparatus was 21 days. The therapeutic results was evaluated at least three months after removal of the apparatus. In all patients it proved possible to influence the flexion contracture by the method of an external fixation device. No complications of treatment were observed. The method and effect of therapy are consistent with the conclusions of work in vitro concerned with the role of traction in the shaping of ligaments.

Adult↗
PubMed1990

[Significance of contrast radiography in the assessment of the state of the muscles and differential diagnosis of extensor contractures of the knee joint].

On the basis of analysis of the roentgen contrast examination of femoral muscles of the patients with extension contractures of knee joint, roentgen systematics of the muscle changes at given pathology is presented and the criteria of differential diagnosis of contractures of different types are proposed. 55 patients (125 examinations) with extension contractures of knee joint (arthrogenic, immobilizing, due to myofascio-tenodesis) of different etiology were subjected to roentgen contrast myography. As a consequence, this offered a means of objective evaluation of the muscle state and enabled one to discover the changes of muscles, specific for contractures in general as well as for each type in particular. The table of roentgenologic signs has been compiled which permits to make differential diagnosis, determine the tactics of treatment, select the type of surgical intervention on the basis of the muscle condition.

Adult↗
PubMed1990

Upper extremity burn contractures.

Upper extremity burn contractures are a major challenge to the reconstructive surgeon. Despite increasing sophistication in the overall management of acute thermal injuries, contractures still occur and are the most common cause of skin contracture in the hand. Reconstructive options for axillary, antecubital, wrist, metacarpophalangeal joint, and interdigital web contractures are discussed, with special emphasis on the techniques and advantages of local flap reconstruction.

Arm↗
PubMed1989

Surgery for adduction contracture of the thumb after burn.

The paper generalizes experience obtained from surgical treatment of adduction contracture of the thumb after burn. These operations were performed on 171 hands. The deformity was repaired using different surgical techniques: local, free and combination operations, use of skin flaps and subcutaneous connective tissue. In the most severe cases of contracture, the thumb abduction was achieved with the aid of a distraction apparatus. The issue under discussion is the choice of a suitable technique for repairing the thumb adduction contracture and other hand deformities. The repair of severe thumb adduction contracture significantly improves occupational and social rehabilitation of patients with severe hand deformities.

Adult↗
PubMed1989

Contractures in patients with Williams syndrome.

Williams syndrome is a multisystem disorder, including a characteristic facies and habitus. Intellectual, neurologic, and cardiovascular dysfunction occur; vascular disease may be progressive. Joint contractures affected 10 of a group of 20 children and young adults. In 3 of 10 patients, the contractures were severe enough to interfere with daily activities; in 3 the effect was only moderate. The contractures developed in early childhood and usually did not improve or worsen with time. Large and small joints were affected and usually were symmetrical. Their occurrence did not correlate with vascular disease. The contractures could not be attributed to a neurologic cause.

Adolescent↗
PubMed1985

Value of hyaluronic acid in the prevention of contracture formation.

Joint stiffness secondary to immobilization was inhibited by intra-articular hyaluronic acid injection in an experimental joint contracture in rabbits. Biochemical and biomechanical parameters were used to evaluate the joint stiffness after nine weeks of immobilization. In all treatments, hyaluronic acid reduced the measured stiffness in the contracture by approximately 50% as compared to the contractures of the untreated rabbits. In addition, hyaluronic acid prevented the loss of glycosaminoglycans (GAGs) (as measured by hexosamine), which normally occurs in untreated contractures. The results are related to a working hypothesis that intra-articular injections of drugs such as hyaluronic acid (Healon-R) will stimulate hyaluronic acid synthesis within the matrices of periarticular connective tissue (PCT). If the spacing and lubricating properties of the glycosaminoglycans could be maintained in the stress-deprived state, the "centripetal collapse" of the fibrillar matrix could be avoided, anomalous cross-links could be minimized, and more normal joint mechanics could be retained.

Animals↗
PubMed1985

[2-stage operative treatment of Dupuytren contracture].

The incidence of Sudeck-like complications after surgery for Dupuytren's contracture is discussed. In a series of 209 operations for Dupuytren's contracture some complications were observed in 26 cases. In 12 patients these complications could not be precisely explained. In the author's opinion they may illustrate the creation of a nerve-irritating source within the operative field. In order to avoid these complications a two-stage operation was proposed, especially for severe contractures in elderly patients. A preliminary fasciotomy relieves most of symptoms of the disease and may also serve as a so-called tissue test for eventual more radical procedures. The observation of 42 patients with severe contractures so treated confirms the usefulness of the method.

Dupuytren Contracture↗
PubMed1983

Protection by S-2-(3-aminopropylamino)ethylphosphorothioic acid against radiation-induced leg contractures in mice.

S-2-(3-Aminopropylamino)ethylphosphorothioic acid (WR-2721) was shown to provide marked protection against development of radiation-induced leg contractures in C3Hf/Kam mice whose legs were exposed to single doses of gamma-radiation. The radiation doses ranged from 3300 to 6200 rads delivered to the right hind thighs from two parallelly opposed 137Cs sources. WR-2721 was given i.p. 30 min before irradiation. The severity of radiation-induced leg contractures in untreated and WR-2721-treated mice was followed for 342 days after irradiation. The degree of leg contractures in both control and WR-2721-treated mice increased up to 100 days after radiation, when the change stabilized, remaining more or less at the same level to the end of the observation period. During this entire period, the severity of contractures was less in WR-2721-treated mice. The dose-modifying factor for the level of 5 mm reduction in leg extension was 1.5 at 182 days after irradiation. Since WR-2721 did not prevent the radiocurability of 8-mm fibrosarcomas growing in the same legs, these data imply that WR-2721 has a high potential for increasing therapeutic gain when combined with irradiation in the treatment of tumors of an appreciable size.

Animals↗
PubMed1983

[Clinical and experimental studies on muscle contracture].

Concerning muscle contracture, etiology, diagnosis and treatment still remain a problem. The author examined diagnosis and treatment clinically and examined the influence of muscle fiber after intramuscular injection of some drugs. Clinical and experimental results were as follows. 1) In the diagnosis of quadriceps muscle contracture, the measurement of buttock elevation phenomenon varies according to the examiner, and in healthy people, the same phenomenon may occur. Hence, the necessity of not over-estimating the phenomenon itself should be emphasized. 2) Adult cases with deltoid muscle contracture are accompanied by pain. 3) Intramuscular injection of chloramphenicol sol on rabbit brought remarkable muscle lesion (fibrosis, lowering of phosphorylase activity) one year after ten consecutive daily injections. Intramuscular injection of chloramphenicol sol causes irreversible lesion in the muscle and this is one of the main causes of etiology of muscle contracture.

Adolescent↗
PubMed1980

[Pathogenesis of secondary contractures of the mimetic muscles].

The results of a clinical and experimental study of the pathogenesis of secondary contractures of mimical muscles are presented. By means of clinico-electrophysiological studies 115 patients with postneuritic contractures are studied. A clinico-statistical analysis of 723 patients with facial nerve neuritis was conducted. For the first time it was possible to model the disease in 112 rabbits with an eventual complex study of the morphological basis and pathophysiological mechanisms of experimental contractures on all stages of its formation. As a result, some ways of accomplishing pathological reflectory influences on the affected nervous-muscular apparatus are defined on the part of the segmentary and suprasegementary structures of the brain stem. It was demonstrated that the direct reason of a disturbed functional state of these structures was an afferent desintegration, due to a crude lesion of the facial nerve and subsequently, it wrong regeneration with a change of the usual scheme of nervous-muscular relations. On the basis of obtained results a pathogenetic therapy of secondary contractures of mimical muscles with Tegretol was proposed and tried clinically.

Animals↗
PubMed1981

Myocardial contracture: the predominant causes of impeded reperfusion in simulated surgical ischemia.

"Worst-case" surgical conditions were simulated using the isolated model of a parabiotically perfused rabbit heart septum. Such conditions occur clinically in regional myocardium distal to stenosed coronary arteries and are characterized by inadequate or absent ionic influence on the myocardium by chemical cardioplegia and equilibration to room temperature. This study tested the hypothesis that ischemic contracture, rather than intracellular or extracellular edema, critical closing or delayed critical opening, was the predominant cause of impeded reperfusion that damages myocardium. In 20 reperfused ischemic septa, conductance (flow per unit pressure) decreased significantly (P less than 0.05) as ischemia at 24 degrees C was prolonged from 15 to 90 minutes and as contracture became more severe. Conductance was not decreased significantly by even large amounts of extracellular edema. Intracellular edema did not occur. In 17 normal septa, the critical closing pressure was 9.3 mm Hg. Critical opening pressures following 5 to 90 minutes ischemia at 24 degrees C did not differ significantly. Although early reflow was impeded progressively with longer ischemic intervals, it was not significant as was due to contracture rather than critical closing or delayed critical opening. This study confirmed the hypothesis that contracture is the predominant cause of impeded reperfusion in simulated surgical ischemia.

Animals↗