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PubMed1997

[Microsurgical tissue autotransplantation in the treatment of postburn deformations, neck and limb contractures].

Microsurgical tissue autotransplantation was used in 133 patients with postburn neck and extremities deformation and contractures. The free nonstretched vascularized scapular, deltoid and thoracodorsal flaps were used in 93 patients with scarring deformations and contractures of the neck. The free stretched scapular flaps on the microvascular anastomoses were used in 30 patients. The stretched and nonstretched flaps can be used successfully for correction of extensive neck and upper extremities scarring deformations and contractures. Good functional and cosmetic results were achieved in 88.7% cases.

Adolescent↗
PubMed1997

Hamstring release for fixed knee flexion contracture in hemophilia.

Sixteen hamstring tenotomies and posterior capsulotomies were assessed retrospectively in 10 patients with hemophilia. The average age of the patients was 17 years (range, 16-24 years). The main indication for surgery was a fixed knee flexion contracture of 30 degrees to 45 degrees, associated with repeated hemarthroses, and failure of conservative treatment after 6 months. A posterior transverse capsulotomy and a Z shaped hamstring tenotomy were performed. The postoperative treatment consisted of repeated stretching exercises for a 6-month period. An average decrease of 25 degrees in the amount of fixed knee flexion contracture was obtained (range, 10 degrees-40 degrees). Followup for an average of 9.5 years showed 11 good, four fair, and one poor result regarding their joint scores. It is concluded that hamstring release is an effective surgical procedure for fixed knee flexion contracture in hemophilia. It seems to reduce the incidence of hemarthrosis relating to such a deformity.

Adolescent↗
PubMed1997

[Results of surgical treatment for Dupuytren contracture].

Early and late results of surgical treatment for Dupuytren contracture within 53 hands in 47 patients aged 19-72 (mean 58) are presented. Early results depended on magnitude of deformity and late ones (3-7 years after surgery) depended on recurrence of the contracture. In patients who had rheumatoid arthritis or the results were slightly worse; pathological changes within the hand were to blame and not the recurrence of contracture itself. No difference in histopathology of this condition was observed between rheumatoid arthritis-group- and ankylosing spondylitis patients.

Adult↗
PubMed1998

[Surgical treatment of knee flexion contracture in children with flaccid limb paralysis using surgical procedures in soft tissues under the knee and serial casting].

Surgical technique and results of surgical correction for substantial flexion contracture of the knee in 15 children with spina bifida or other spinal conditions with lower extremities paresis is presented. Extensive posterior capsulotomy, occasionally supplemented with posterior cruciate sectioning is necessary to correct considerable flexion contracture of the knee. The technique is also effective in congenital flexion contracture with no articular surfaces deformity. Serial redressing and casting are imperative in postoperative management.

Adolescent↗
PubMed1998

The column procedure: a limited lateral approach for extrinsic contracture of the elbow.

Thirty-eight elbows (thirty-seven patients) with an extrinsic contracture were treated operatively with a limited lateral approach to the anterior and posterior aspects of the capsule. Because the procedure elevates muscles from the anterior and posterior aspects of the lateral supracondylar osseous ridge, we called it the column procedure. The mean preoperative arc of flexion was 49 degrees (from 52 to 101 degrees). At a mean of forty-three months (range, twenty-four to seventy-four months) postoperatively, the mean arc of flexion was 94 degrees (from 27 to 121 degrees). The mean total gain in the arc of flexion-extension was 45 degrees; thirty-four elbows (89 percent) had an improved range of motion at the latest follow-up examination. Overall, thirty-one elbows (82 percent) had a satisfactory result. Greater improvement was obtained in elbows that had had severe stiffness (a total arc of 31 to 60 degrees) or very severe stiffness (a total arc of 30 degrees or less) or that had had a combined flexion and extension contracture. A complication occurred in four elbows (11 percent). A hematoma developed in two elbows and impaired the final outcome in one of them. Two elbows had transient ulnar paresthesia, which resolved spontaneously. The arc of flexion obtained at the time of the operation was lost in ten elbows (26 percent) after an initial period of improvement; at the latest follow-up evaluation, four of these elbows had a mean decrease in the arc of flexion of 24 degrees compared with preoperatively. The column procedure is associated with a low rate of complications and is safe and effective for the treatment of a limitation in flexion or extension resulting from an extrinsic contracture of the elbow.

Adolescent↗
PubMedDate not supplied

[The morphofunctional validation of the use of vibration-traction for the correction of contractures of the joints].

Experiments in modelling joint contracture have shown that vibrotracture with step-by-step frequency rise in one procedure and discrete rise in traction power in the course of procedures may correct joint contracture. Basing on these experimental findings, the authors have developed highly effective method of vibrotraction treatment of joint contractures (patent N 1804819).

Animals↗
PubMed2004

Multiminicore disease in a family susceptible to malignant hyperthermia: histology, in vitro contracture tests, and genetic characterization.

BACKGROUND: Histological anomalies associated with malignant hyperthermia (MH) have been scarcely reported. In some patients susceptible to MH (MHS), central cores have been identified and a genetic association has been proposed, but multiminicore lesions have not been systematically reported. OBJECTIVE: To analyze the association between multiminicores and MHS in a large family with MH with an approach combining histology, in vitro contracture tests, and genetic analysis. PATIENTS AND METHODS: Twenty-nine members of an MH family (147 members) were investigated. MAIN OUTCOME MEASURES: Muscle biopsy specimens were analyzed histologically and with in vitro contracture tests. Genetic analyses were performed to determine the presence of mutations in the ryanodine receptor (RYR1) gene. RESULTS: According to the gold standard in vitro contracture tests, 17 patients were diagnosed as having MHS and 10 as not being susceptible. Multiminicores were found in 16 of the 17 MHS patients and in a single nonsusceptible participant. A linkage between the MH trait and the RYR1 locus in chromosome 19 was demonstrated, whereas no already known mutations were found. Two missense heterozygous mutations (R2676W and T2787S) were identified from sequencing of the entire coding complementary DNA. Overall, we found a significant association between MHS and the presence of multiminicores (chi(2) = 26.5, P<.001) on the one hand and the presence of new mutations in the RYR1 gene (chi(2) = 19.0, P<.001) on the other hand. This remarkably high occurrence of multiminicores in an MHS family is uncommon, and genetic analyses indicate that the association between multiminicores and MHS is linked to a novel R2656W and T2787S substitution present on the same allele of the RYR1 gene. CONCLUSIONS: These results indicate that multiminicore lesions are observed in MHS patients with neither clinical signs related to multiminicore disease nor histological features of congenital myopathies. These multiminicore lesions may be secondary to mutations in the RYR1 gene. As a consequence, these patients must be distinguished from patients with multiminicore disease and from other MHS patients for whom multiminicores are not observed.

DNA Mutational Analysis↗
PubMed1980

Inhibition of caffeine contractures of slow rat muscles by urea and its derivatives.

Contractures induced by rapid cooling of rat soleus muscles in the presence of low concentrations of caffeine (2-3 mmol.l-1) have been studied. Urea, methylurea and 1,3-dimethylurea inhibit reversibly these contractures as well as caffeine contractures (20 mmol.l-1, 30 degrees C) but do not affect twitches. This finding leads support to the idea of the existence of different mechanisms activating contraction in response to caffeine action or deplorization.

Animals↗
PubMed1988

The effect of D600 on potassium contractures of slow muscle fibres of Rana temporaria.

(1) The effect of 30 microM D600 on the amplitude and time course of isometric contractures was studied in single slow fibres of Rana temporaria. (2) D600 only slightly reduced the amplitude of contractures evoked with 30 or 95 mM K-Ringer's. Maintenance of tension was strongly impaired by D600 only during exposure to 95 mM K. The caffeine contracture was not affected. (3) Addition of 10 mM Ca2+ or other divalent cations to the medium strongly counteracted the effect of D600 on maintained tension. The order of efficiency was Ca2+ = Ni2+ greater than Co2+ greater than Mn2+ much greater than Mg2+. (4) During 2 min exposure to 95 mM K-Ringer's the slow fibres inactivated to a variable degree; recovery from inactivation in normal Ringer's proceeded with a half time of the order of 1 min, while in the presence of D600 recovery was prolonged 3.3 to 27 times. (5) It is concluded that the effect of D600 on the contractile behaviour of slow fibres from Rana temporaria is predominantly due to a prolongation of the inactivated state. It is suggested that D600 binds to a site at the outer membrane surface which also binds divalent cations and determines the degree of contractile inactivation during exposure to potassium. Blocking of Ca2+ channels is unlikely to be the mechanism of this D600-effect.

Animals↗
PubMed1987

Decrease in force potentiation and appearance of alpha-adrenergic mediated contracture in aging rat skeletal muscle.

The effect of increasing age on contractile performance and catecholamine receptor activity was investigated in a distal, predominantly fast twitch oxidative glycolytic (FOG) muscle from the plantar surface of the rat hindfoot. The ability of the flexor digitorum brevis (FDB), isolated from anesthetized rats and maintained in vitro, to undergo post-tetanic potentiation and a staircase response declined with age. Potentiation following repetitive stimulation was reduced by 50% in 2 year old rats and eliminated in 3 year old animals. The rate of muscle fatigue during intermittent tetanic stimulation also increased in aging muscles. FDB, regardless of age, did not develop a positive inotropic response to 10(-6) M epinephrine applied in vitro, but 3 year old FDB generated a prolonged contracture. Contracture tension was approximately 25% of twitch tension and was maintained for 2-10 min in the continued presence of catecholamine. Contractures were eliminated by pretreatment with alpha-adrenergic antagonists or by removing Ca2+ from the bathing medium. In addition to decreased contractile capacity, aging muscles acquire a population of alpha-adrenergic receptors which may underlie some of the metabolic and structural changes associated with increasing age.

Aging↗
PubMed1982

The in-vitro caffeine contracture test: influence of the muscle histochemical profile on test results.

In vitro caffeine contracture tests were carried out on whole rat muscle composed primarily of either histochemical type I or type II fibers. Muscles composed primarily of type I fibers developed contractures at lower concentrations of caffeine and had lower caffeine specific concentrations than muscles composed primarily of type II fibers. These findings indicate that the histochemical profile of a muscle can influence the results of the in-vitro caffeine contracture test.

Animals↗
PubMed1982

Effect of abolition of fetal movement on fetal intravascular PO2 and incidence of tonic myometrial contractures in the pregnant ewe at 114 to 134 days' gestation.

The possibility that fetal movements play a role in the initiation of the bursts of tonic myometrial activity (contractures) that occur throughout the second half of pregnancy in the sheep has been examined by the administration of the curare derivative pancuronium to abolish fetal movement. The duration and frequency of the electromyographic bursts associated with contractures, as well as the increase in intrauterine pressure generated by the contractures, were unchanged. However, within 1 hour of the abolition of fetal movement, fetal jugular venous PO2 was significantly elevated and remained elevated for at least 6 hours. This observation is in keeping with the view that fetal skeletal muscle movement consumes significant amounts of oxygen.

Animals↗
PubMed1988

Effect of fiber types, fascicle size and halothane on caffeine contractures in rat muscles.

Caffeine contractures were recorded from thin bundles and whole extensor digitorum longus (EDL) and soleus muscles of rat, and correlated with preparation size and fiber types. Thin bundles were more sensitive to caffeine and halothane than whole muscles, and bundles of 100% type I fibers were more sensitive than bundles of 100% type II fibers. Magnitude of contracture had significant correlation with maximal tetanic tension, total number of fibers, thickness of the preparation, and proportion of type I fibers. These results suggest that fascicle size and fiber types significantly affect results of in vitro contracture test for susceptibility to malignant hyperthermia.

Animals↗
PubMed1986

TMB-8 can block twitches without blocking high K+ or caffeine induced contractures in frog's skeletal muscle.

TMB-8 [8-(diethylamino)-octyl-3,4,5-trimethoxybenzoate] is known to inhibit calcium ion dependent processes in several tissues by stabilizing some intracellular stores of membrane-bound calcium. TMB-8 was used to study the excitation-contraction (E-C) coupling process in frog's skeletal muscle. TMB-8 (5 X 10(-5) - 10(-4) M) blocked electrically evoked twitches but not high K+ (123 mM)- or caffeine (2.36 mM)-induced contractures in isolated, curarized toe muscles. TMB-8 (10(-4) M) produced a small decrease (16%) in the action potential of frog's sartorius muscle fibres. However, reducing extracellular Na+ to 44.7 mM produced a similar reduction (17%) in action potential amplitude but did not suppress the twitch; i.e. it produced only a small increase (about 10%) in twitch amplitude. It is known that potassium contractures are produced by extracellular Ca++ ions which enter through calcium channels in the t-tubules and that caffeine produces contractures by sensitizing the sarcoplasmic reticulum to Ca++-induced Ca++ release. The present results suggest that TMB-8 blocks twitches by preventing the release of Ca++ ions bound to the intracellular surface of the t-tubular membrane which is often called the store of 'trigger-calcium' ions.

Action Potentials↗
PubMed1993

Caffeine contractures, twitch characteristics and the threshold for Ca(2+)-induced Ca2+ release in skeletal muscle from horses with chronic intermittent rhabdomyolysis.

Muscle from horses with intermittent exercise associated rhabdomyolysis was examined to determine if calcium regulation was abnormal. In vitro studies on semimembranosus muscle fibre bundles showed the time to 50 per cent relaxation of caffeine-induced contractures was shorter and the electrically elicited twitch longer in horses with exercise associated rhabdomyolysis. Substitution of strontium for calcium eliminated the difference in caffeine contracture between the normal and rhabdomyolysis horses. The threshold of calcium-induced calcium release was lower than normal in terminal cisternae-containing fractions of muscle from horses with rhabdomyolysis. Thoroughbreds with rhabdomyolysis had a shorter time to peak twitch tension than standardbreds, and normal thoroughbreds had a shorter caffeine contracture than normal standardbreds. There was no difference in fibre typing between breeds or groups. Either no histological changes or low grade to moderate degenerative myopathy was seen in muscle from horses with rhabdomyolysis. These results suggest horses with intermittent exercise associated rhabdomyolysis have abnormal calcium regulation.

Animals↗
PubMed1985

Pattern of contracture and recovery following ischaemia of the upper limb.

196 cases of Volkmann's Ischaemic Contracture of the upper limb with well-established ischaemia are presented. In all cases tight external circumferential splintage was the primary factor. 59.2% of these patients had been initially treated by "bone setters". 54.6% had fractures of the forearm; supracondylar fracture of the humerus was seen in 10.7% and 17.9% had no evidence of bone or joint injury. Different patterns of ischaemic contractures are recognised and the severity of the contracture is found to be related to the extent of paralysis. Sensory recovery occurs in a proximodistal direction even following total ischaemia and degeneration of the nerve. Motor recovery, however, does not seem to take place. Sensory recovery in the forearm proceeds rapidly in the first six months; thereafter it is less significant. However, the sensory recovery in the hand is significant only after more than twelve months. Since sensory recovery occurs even after total ischaemic degeneration of the nerve it is postulated that such nerves recover and regenerate in course of time.

Adolescent↗
PubMed1989

CT in established Volkmann's contracture in forearm muscles.

Differential diagnosis between true and pseudo-Volkmann's contracture should not be based on clinical grounds alone, because clinical data are often insufficient in determining the severity and the extent of muscle damage. CT has been utilised in 11 cases where a flexion contracture of the forearm muscles was present and corresponded closely with the surgical findings. True and pseudo-Volkmann's contracture can thus be distinguished and the severity and extent of the muscle damage determined.

Adolescent↗
PubMed1996

Burn scar contracture release: a simplified technique utilizing contact media.

A technique to overcome the problems of inlay grafting for burn scar contracture release is described. A greater release can be achieved by moving the point of release away from the flexure crease, with the added advantage of grafting on to a 'flat non-mobile' surface. A simplified method of graft fixation and compression is described, along with the use of contact media in the postoperative management to prevent graft shrinkage and the recurrence of contracture. During a 6-year period, burn scar contracture release with inlay grafting was performed on 24 patients (10 limbs with 17 split-skin grafts and 14 fingers with 21 full-thickness grafts) with no recurrence.

Burns↗