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PubMed2002

Electromyographic activity of the jaw-closing muscles during jaw opening in patients with masseter muscle contracture.

Contracture of the jaw-closing muscles is one of the causes of limitation of jaw opening. This study examined whether there is any difference between the EMG activities of jaw-closing muscles during jaw opening in healthy people and in patients with masseter muscle contracture (MMC), who do not have a history of trauma or infection. The patient group consisted of eleven females, 18 to 62 years old with no history of trauma or infections, with limited mouth opening due to MMC. The control group included eleven healthy females, 23 to 50 years old. The EMG activity was recorded bilaterally in the central portion of masseter muscles (Mm), the anterior portion of temporal muscles (Tm), and the anterior belly of digastric muscles (Dm). Nine out of the patient group showed obvious EMG activity in Mm during jaw opening which was different from typical EMG patterns during jaw opening of up to 40 mm in the control group. Among the nine patients, eight showed antagonistic contraction in Tm as well as Mm. The mean integral value of Mm and Tm during jaw opening in the patient group was significantly higher than in the control group (P<0.01). These results suggest that EMG activity during jaw opening in MMC patients with no history of trauma or infections is different from that in healthy people.

Adolescent↗
PubMed1962

Water loss during contracture of muscle.

The relationship of contracture and exudation of water in frozenthawed frog muscle was studied. With maximum shortening, there was a water loss of 35 per cent of the weight of muscle. By restricting the contraction, it was demonstrated that the amount of water loss was proportional to the degree of shortening, there being no significant loss with isometric contraction. Muscle already shortened by tetanic stimulation also exuded water on subsequent freezing and thawing. The force of contraction could be reduced by depleting the muscle of calcium and it was shown that the amount of water exuded was also proportional to the tensile ability of the muscle. In a smooth muscle (anterior byssus retractor of Mytilus) which did not contract vigorously only a little water exuded. Contracture produced by caffeine was similarly associated with a loss of water. Microscopic studies revealed a disruption of the sarcomeres of the frozen-thawed muscle which contracted; glycerol-extracted and calcium-depleted muscles, which did not contract on freeze-thawing, did not show such disruption. Freezing and thawing of actomyosin caused a reversible syneresis of the protein. It is concluded that the exudation of the water is not merely due to the freezing and thawing but is also dependent on the contractile events.

Actin Cytoskeleton↗
PubMed1964

THE RECOVERY OF CONTRACTILE ABILITY FOLLOWING A CONTRACTURE IN SKELETAL MUSCLE.

When the potassium in Ringer's solution is increased above 25 mM, frog skeletal muscle contracts and then spontaneously relaxes. Elevated external potassium will not produce tension again until the stimulating potassium has been removed and a recovery process has taken place. The kinetics of this recovery reaction have been studied in toe muscles bathed in choline Ringer's solutions in which the levels of Ca and K were varied. In 2.5 mM K the recovery reaction appears to follow first order kinetics and the recovery is slowed by lowering the external Ca. In 1.8 mM Ca the recovery is complete in 60 sec.; in 0.2 mM Ca it is 70 per cent complete. When the external K is increased to 10, 15, or 20 mM, the recovery reaches a maximum at 60 sec. and then declines. As the external K is increased, the maximum recovery achieved declines. At K concentrations above 20 mM there is no recovery. When the external Ca is reduced to 0.2 mM, the area under the contracture tension curve is reduced by 40 +/- 3 per cent (mean +/- SEM). When 1.6 mM Ni is added to 0.2 mM Ca Ringer's, the contracture area is restored beyond the control value. This addition of the Ni to 0.2 mM Ca Ringer's does not, however, restore the recovery reaction to its rate in 1.8 mM Ca.

Animals↗
PubMed1980

Review of physical therapy alternatives for reducing muscle contracture.

Passive stretching is a technique frequently used to treat muscle contractures; however, because it can activate the stretch reflex and has little carry-over, it may not be as effective as other modes. Four approaches to treating muscle contracture are described: 1) activation or strengthening of the weak oppnent, 2) local inhibiton of the contractdd muscle, 3) general inhibition of hypertonus, and 4) passive lengthening. Specific examples of techniques, their rationales, and suggestions for use of each are discussed.

Contracture↗
PubMed1990

Use of serial casting in the management of knee joint contractures in an adolescent with cerebral palsy.

Treatment of adolescents with cerebral palsy often presents clinical problems that differ from those encountered when treating younger children with cerebral palsy. Muscle contractures, which may not yield to traditional therapeutic exercise, may be a problem. The purpose of this case report is to describe the use of serial casting in the treatment of knee joint flexion contractures in an adolescent with cerebral palsy.

Adolescent↗
PubMed1980

The influence of vitamin E on capsule formation and contracture around silicone implants.

An attempt was made to determine if the tissue response to surgical trauma and foreign body stimulus (silicone implants) could be altered using vitamin E in rats. The animals were divided into four groups: Group A served as controls, Group B were treated by intramuscular vitamin E, Group C were treated topically with vitamin E around the prosthesis, and Group D were treated topically with croton oil around the prosthesis. The animals in each group were killed at 2 week, 1 month, and 3 months intervals. The intraprosthetic pressure in each prosthesis was recorded using a strain gauge transducer. The capsules were then removed and examined histologically using a light microscope and the thickness of pseudocapsules was measured with an ocular micrometer. In Group B significantly thinner pseudocapsules were observed at 2 weeks, but there was no comparable difference either in thickness or degree of contracture (as measured by intraprosthetic pressures) between Groups A and B at 2 months and 3 months. In Group C, the pseudocapsules were significantly thicker at all tested periods and showed noticeable contracture at 3 months. In group D the pseudocapsules were thickest and cellular infiltrate more marked than in the other groups.

Administration, Topical↗
PubMed1991

Tissue expansion in reconstruction of postburn contracture of the first web space of the hand.

The successful release of severe contracture of the first web space depends on addition of a sufficient amount of skin. Because local skin is limited, skin grafts tend to contract, and free and pedicle flaps are bulky, further procedures are often obligatory. Expansion of the tissues of the dorsum of the hand offers an effective and relatively simple approach to generate the excess skin needed. We present a patient in whom an inflatable silicone implant was used to correct recurrent first web space contracture after burns.

Adolescent↗
PubMed2000

Correction of axillary burn scar contracture with the thoracodorsal perforator-based cutaneous island flap.

Axillary scar contracture is observed frequently after severe burn insult and is usually accompanied by injuries to the adjacent area. Although many therapeutic methods, including skin grafting, Z-plasties, local flaps, island flaps, and free flaps, have been established, each technique has its own advantages and disadvantages in specific situations. The decision regarding which technique to use can only be made after consideration is given to the merits of the individual case. We applied thoracodorsal perforator-based cutaneous flaps to 5 patients with axillary burn scar contractures and damaged adjacent tissues. In 1 patient both axillae were involved. Elevated flaps as large as 11 x 27 cm in size were used. All flaps survived completely even when raised in scar tissue. The donor sites were closed primarily except one, which needed a skin graft. Three patients obtained satisfactory release with more than 160 deg shoulder abduction. In 2 patients, release was incomplete with only 110 deg shoulder abduction, but neither one required a second release. The range of motion in terms of shoulder abduction was improved preoperatively (30-90 deg) to postoperatively (110-170 deg). The thoracodorsal perforator-based cutaneous flap presents a very useful reconstructive method for the treatment of axillary defects.

Adult↗
PubMed2002

Bilateral side finger transposition flaps in the treatment of chronic postburn flexion contractures of the fingers.

The authors present a surgical method of releasing postburn flexion contracture of the finger by two separate transverse incisions and covering the skin defects by transposing two random-pattern flaps from both sides of the finger. One of the proximally based flaps was transposed from one side of the proximal phalanx and the other flap was transposed from the opposite side of the middle phalanx. Because the flaps were raised from different sides of different phalanxes, the donor sites were closed primarily. A total of 37 fingers (14 hands, 11 patients) were treated with this method. The patients were all men aged 20 to 24 years old. The mean follow-up period was 9 months. The lack of extension of the proximal interphalangeal joints of the fingers was improved by approximately 45 deg using the described method. The authors conclude that this method can be used effectively in the treatment of mild to moderate postburn flexion contractures of the fingers.

Adult↗
PubMed2000

Surgical treatment of extraarticular elbow contracture.

The problem of the contracted elbow is well-recognized for the circumstances under which it develops and the difficulty of operative and non-operative treatment. Earlier studies report this problem in an unfavorable manner; however, current studies suggest that posttraumatic stiffness of the elbow, particularly when the articular surface is left intact, may be treated reliably. The authors present a specific surgical approach to the elbow that has posttraumatic motion limitation described as extrinsic, that is, primarily attributable to contracture of the capsule and periarticular soft tissues. The limited surgical exposure termed the column procedure allows anterior capsular exposure through an interval in the brachioradialis and extensor carpi radialis longus. Using this procedure the authors report the treatment of 38 elbows (38 patients) with sufficient followup to accurately describe the postoperative course. At a mean of 3.5 years after surgery the total postoperative arc of motion improved from approximately 50 degrees to approximately 90 degrees. There were minimal complications. A static adjustable splint rather than physical therapy is used postoperatively. It is concluded that newer surgical techniques with carefully described programs can be successful in the majority of patients undergoing surgical release for extrinsic contracture of the elbow.

Contracture↗
PubMedDate not supplied

Comparison of scar contracture with the use of microskin and Chinese-type intermingled skin grafts on rats.

Wounds that were measured precisely 4 x 5 cm in size were created over the dorsal surfaces of rats. The defects were grafted with the use of either the microskin or Chinese technique of intermingled auto/allograft with an expansion ratio of 10:1. The size of the grafted wound of each rat was recorded on the fifth graft day after grafting and then weekly for 11 weeks. The extent of scar contracture on each rat was calculated weekly as a percentage of the original size. The results showed that the scar contracture associated with the Chinese type of intermingled auto/allograft transplantation was less than that associated with the microskin technique. The healing process in both forms of grafting was uneventful.

Animals↗
PubMedDate not supplied

Serial casting as a technique to correct burn scar contractures. A case report.

Serial casting is a fast, relatively simple, and inexpensive way to effectively correct burn scar contractures. Plaster casts provide circumferential pressure and a prolonged stretch to contracted tissue and cannot be removed by the patient. When casts are applied well and padded appropriately, there is little risk of pressure areas, since the casts are conforming and do not slip distally. Serial casting may be a successful alternative when low-force dynamic splinting cannot be sized small enough for a child, or when patient compliance is unreliable. A case study of a 2-year-old male patient with severe plantar-flexion contractures of the ankles is presented.

Ankle Joint↗
PubMed1975

Advantages of double releases in axillary, antecubital and popliteal contractures.

The advantages of the double release technique in axillary contractures are discussed. The procedure is useful for releasing contractures involving the antecubital and popliteal spaces as well. The risk of cutting vital structures involved in the scar tissue is minimized; also, the skin in the center of the axilla, if infected or ruptured, can be covered without as much threat to the axillary space. In addition, by placing the skin grafts on the surfaces at edges of the antecubital or in the popliteal space, the take of the skin graft on a flat surface is better insured.

Axilla↗
PubMed1976

Spherical contracture of fibrous capsules around breast implants. Prevention and treatment.

A follow-up of 82 patients who had had augumentation mammaplasties is reported. Though the number of patients having had each form of ancillary treatment is small, we believe that intraoperative instillation of triamcinolone and postoperative "expansion exercises" are of value in decreasing the incidence of capsular contracture around the implants. When such spherical contracture does occur, the capsule can usually be ruptured simply and quickly by external pressure with the surgeon's hands. This is usually done as an office procedure, without anesthesia. The results are so beneficial that we believe this should be done on many patients. In some it may need to be done repeatedly.

Breast↗
PubMed1981

The etiology of hypertrophic scar contracture: another view.

A new theory of hypertrophic scar contracture is proposed which accounts for many hitherto unexplained clinical and microscopic characteristics. The primary motive force is limb flexion with the mucopolysaccharide "glue" locking the buckled collagen in the contractured position. A different role for the myofibroblast is postulated.

Cicatrix↗
PubMed1981

The effectiveness of alpha-tocopherol (vitamin E) in reducing the incidence of spherical contracture around breast implants.

Vitamin E appears to be a safe, simple, and inexpensive means of reducing the number of postoperative capsular contractures following breast augmentation. The synthetic form of vitamin E (alpha-tocopherol) is recommended to avoid nausea or skin eruptions in patients with oily skin, which are frequently encountered when the natural form is taken. No harmful side effects have been noted in any of the patients to date. Vitamin E has no effect on coagulation systems and does not cause excessive bleeding either during or after surgery. The recommended dosage of synthetic vitamin E is 1000 IU, b.i.d., for 2 years beginning 1 week before surgery. If no contracture exists at that time, the dosage may be reduced to 1000 IU daily thereafter.

Breast↗
PubMed1982

Ultrastructural relationship of skin to nodule and cord in Dupuytren's contracture.

The interface of skin and nodule or cord was studied in Dupuytren's contracture in 11 patients using light and electron microscopy. Four distinct anatomic zones were seen in he skin/nodule specimens, with three zones in skin/cord. Skin/nodule specimens had a striking horizontally layered dense band just underneath the dermis, a feature not found in skin/cord specimens. Electron microscopy showed active contractile fibroblasts (myofibroblasts) in the lower two zones in skin/nodule, with clusters of active and degenerating cells side by side. No myofibroblasts were seen in either the skin/cord or any skin specimen. These data suggest that the nodule is the active source of contraction in Dupuytren's contracture. Skin overlying both nodule and cord appears to be drawn passively by underlying contraction forces. A local defect in palmar skin may prevent normal inhibition of myofibroblast contraction. More aggressive resection of fascia and dermis may be indicated in skin/nodule areas.

Dupuytren Contracture↗