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PubMed1983

Flexion contractures of the knee associated with popliteal webbing.

Five children with popliteal webbing and flexion contractures of the knees are described. When their associated anatomical abnormalities are considered, classification into two distinct syndromes, multiple pterygium and popliteal pterygium, is possible and of importance in genetic counseling. Soft tissue surgical corrections of the flexion contractures were undertaken in each case. The operative technique, local abnormalities, and orthopaedic management are discussed.

Abnormalities, Multiple↗
PubMed1984

Posterior capsulotomy for the treatment of severe flexion contractures of the knee.

Twenty-nine patients (42 knees) with severe flexion contracture of the knee (average 69 degrees) were treated by posterior capsulotomy followed by traction and/or casting. Twenty patients (28 knees) had poliomyelitis. After a follow-up of 21/2 years, 39 knees were corrected to less than 15 degrees of flexion. All of the patients except one were able to ambulate using a knee-ankle-foot orthosis, with or without crutches. Complications included skin necrosis in nine patients, recurrence in six, hypertension in three, and peroneal nerve palsy in one. The rate of complication was less in patients with poliomyelitis. This method is recommended for the treatment of severe flexion contracture of the knee, especially in patients with poliomyelitis, but is not recommended in patients with insensitive skin.

Adolescent↗
PubMed1984

Hereditary tendo Achillis contractures.

A study was performed on eight patients with tendo Achillis contractures. Family histories were obtained and a short regimen of casting was performed. Hereditary tendo Achillis contracture is an autosomal dominant condition with variable expression. It is a relatively benign condition that is both a cosmetic and functional problem for the patient. The disorder responds well to a short course of casting. Follow-up exercises are necessary to maintain normal ankle motion and heel strike during gait. Operative treatment was not necessary in these patients.

Achilles Tendon↗
PubMedDate not supplied

Muscle weakness and congenital contractures in a case of congenital myasthenia.

A case of nonautoimmune, prenatal-onset, congenital myasthenia with congenital contractures including camptodactyly is presented. The clinical features re identical to those in three previously reported cases. In this form of congenital myasthenia, the muscle weakness and congenital contractures may resolve completely after conservative treatment, including anticholinesterase medication. Diagnosis can be made by the characteristic clinical history, neurological assessment, and electromyography with repetitive nerve stimulation.

Contracture↗
PubMedDate not supplied

Surgical release of elbow-capsular contracture in pediatric patients.

Nine pediatric patients with elbow-capsular contractures were treated by surgical release. Six patients had sustained prior trauma and three patients had medical conditions leading to capsular contracture. A lateral approach was used to release the anterior and posterior capsules, as well as to remove sites of bony impingement. All patients were treated with postoperative range of motion and splinting, with six patients receiving a continuous brachial plexus block to facilitate therapy. Average loss of extension improved from 47 to 15 degrees, mean angle of flexion from 102 to 124 degrees, and total arc of motion increased from 55 to 108 degrees at an average of 17 months after surgery. Complications included wound infection and catheter-site erythema.

Adolescent↗
PubMed1987

X-linked muscular dystrophy with early contractures and cardiomyopathy (Emery-Dreifuss type).

The original Virginia family with X-linked muscular dystrophy with early contractures and cardiomyopathy (Emery-Dreifuss type) has been reinvestigated 25 years later. The findings confirm that a cardiomyopathy, presenting most often as atrioventricular block, is a significant feature of the disease, which is characterized by the triad of: 1) slowly progressive muscle wasting and weakness with a humero-peroneal distribution in the early stages; 2) early contractures of the elbows, Achilles tendons, and post-cervical muscles; and 3) a cardiomyopathy usually presenting as heart block (some female carriers may also develop heart block). Other reported families with X-linked Emery-Dreifuss muscular dystrophy as well as a rare autosomal variant are reviewed, and differentiation from scapulo-peroneal muscular dystrophy and the rigid spine syndrome is discussed.

Contracture↗
PubMed2004

Recurrent posterior capsular opacification and capsulorhexis contracture after cataract surgery in myotonic dystrophy.

Cataracts are well known to be associated with myotonic dystrophy. Less well known are the phenomena of recurrent posterior capsule opacification and capsulorhexis contracture post cataract surgery. Two cases are described herein of postoperative capsular complications requiring multiple capsulotomies in patients with myotonic dystrophy. It is proposed that a common aetiology may underlie both posterior capsule opacification and capsulorhexis contracture in myotonic dystrophy cases.

Adult↗
PubMed1984

'Firebreak' grafts in Dupuytren's contracture.

The empirical observation that Dupuytren's Contracture does not recur beneath a skin graft is applied as a means of controlling recurrent Dupuytren's Disease. In those patients with a strong inherited diathesis to the production of Dupuytren's Contracture, recurrence may occur or even by anticipated, and the placement of a skin graft strategically at a flexion crease is shown to act as a 'firebreak' between areas of potential flare-up of recurrent Dupuytren's Disease.

Disease Susceptibility↗
PubMed1997

Safety of silicone liquid in the postoperative management of Dupuytren's contracture.

BACKGROUND: Recently the New Zealand Department of Health expressed concerns about the safety of applying silicones to open wounds and banned their use. For 30 years silicone liquid has been used for the management and rehabilitation of the injured hand. It has been reported that the application of silicone fluids to the skin and ordinary handling over a period of years of various methyl and phenyl polymers by laboratory workers caused no skin disorders or sensitization, nor was absorption observed. There are no reports in the literature of the safety of the use of silicones applied to open wounds. METHODS: In the present study, 116 hands that had been mobilized in silicone liquid following surgery for Dupuytren's contracture over the last 12 years were reviewed. In the cases of 64 hands, the patients could be traced and contacted, and 47 patients (hands) agreed to attend for a clinical review. The hands were examined for areas of inflammation, granuloma formation and abnormal scar formation. RESULTS: No patient showed any evidence of adverse effects from the use of silicone liquid. CONCLUSIONS: There is no evidence that the use of silicone liquid, in contact with open wounds of the hands, for the mobilization of the hand following surgery for Dupuytren's contracture has any of the adverse effects reported as being associated with implanted silicone prostheses.

Adult↗
PubMed1981

Treatment of extension contracture of the hip in cerebral palsy.

Twenty patients with cerebral palsy had a total of 35 extension contractures of the hip, resulting from tightness of the gluteus maximus or hamstring muscles, with associated quadricepts muscle spasticity. Associated deformities included anteriorly dislocated hips, patella alta, lumbar lordosis, thoracic kyphosis and calcaneus feet. Active and passive exercises, surgical release of contractures and reduction of anteriorly dislocated hips improved function. Hip flexor or adductor tenotomies must be considered cautiously for patients with spastic hip extensor muscles, because severe extension constricture may develop after either procedure.

Adolescent↗
PubMed1994

Temporomandibular joint contracture in spastic quadriplegia: effect on oral-motor skills.

This study assessed the temporomandibular joint of 34 children with spastic quadriplegic cerebral palsy for contractures to determine whether joint abnormalities were related to oral-motor dysfunction. Subjects were found to have restrictions in mandibular range of motion, increased overjet and decreased overbite. Increased overjet corresponds to retrognathia and decreased overbite relates to fixed posterior rotation of the mandible. The severity of many of these abnormalities correlated with the severity of oral-motor dysfunction. Abnormalities in overbite were particularly significant. The authors conclude that temporomandibular joint contractures in this population are related to problems in oral-motor function. It is hoped that further research in this area will lead to new therapies for children with feeding and swallowing problems.

Adolescent↗
PubMed1984

Pancuronium bromide induced joint contractures in the newborn.

We report three infants paralysed with pancuronium bromide as an adjunct to mechanical ventilation, who developed multiple joint contractures. In two term infants, gentamicin and phenobarbitone given together with pancuronium may have potentiated its effect, and in one preterm infant contractures, which became more severe after paralysis, were present at birth.

Contracture↗
PubMed1992

Knee contractures as the presenting manifestation of scleroderma.

Musculoskeletal disorders may be the primary manifestations of scleroderma. The case is reported of a patient admitted for an evaluation of severe knee flexion contractures who was diagnosed as having scleroderma but lacked the typical presenting features of the disease. Radiographic, serological, and histological support for this diagnosis are presented. Scleroderma should be considered in the diagnostic evaluation of joint contractures.

Aged↗
PubMed1982

Dupuytren's contracture in manual workers.

The incidence of Dupuytren's contracture in a polyvinyl chloride (PVC) manufacturing plant, where a great deal of bagging and packing took place by hand, was higher than in another plant in which there was no bagging or packing. The incidence in the packing plant was double that found in an earlier survey by Early at Crewe Locomotive Works of 4801 individuals, most of whom were manual workers. The implication is that the nature of the work of bagging and packing in our PVC compounding plant may have triggered Dupuytren's contracture.

Adolescent↗
PubMed1985

Case of quadrilateral flexural contracture in a 10-year-old pony.

The management of a case of quadrilateral flexural contracture in a 10-year-old pony is described. The animal was restored to normal appearance and function through a combination of surgical desmotomy and management techniques; the importance of analgesia and exercise as adjuncts to surgery is emphasised. The aetiology and pathogenesis of the condition in the immature animal and the adult is compared and a possible association is made between this condition and palmar fibromatosis (Dupuytren's contracture) occurring in man.

Anesthesia, General↗
PubMed2003

Clinical results of arthrolysis using postero-lateral approach for post-traumatic contracture of the elbow joint.

We evaluated clinical results and postoperative problems associated with arthrolysis for post-traumatic contracture of the elbow joint. Arthrolysis was carried out in 47 elbows in 46 patients. Age at the time of arthroplasty ranged from 12 to 64 years (average 33 years). The period from time of injury to arthrolysis ranged from six months to six years (average 16 months). It was notable that scarring of the anterior capsule was pronounced in cases of long-term contracture. No apparent differences were observed in causes or age at operation, but the duration of preoperative symptoms and period of postoperative external fixation tended to affect the outcome. We conclude that arthrolysis is indicated irrespective of preoperative range of motion (ROM) and age, and that the surgery should be carried out before degeneration of cartilage and muscle atrophy progress. It was considered that long-term postoperative observation is also necessary, because in some cases there was postoperative progression of joint deformities, while in others there was decreased muscle strength after surgery.

Adolescent↗
PubMed2004

Glenohumeral deformity in children with internal rotation contractures secondary to brachial plexus birth palsy: intraoperative arthrographic classification.

PURPOSE: To evaluate, with intraoperative arthrography, joint morphology in children undergoing surgical treatment of residual paralysis of the shoulder resulting in brachial plexus birth palsy and to correlate the morphology with the degree of passive external rotation. MATERIALS AND METHODS: In 64 children (age range, 7 months to 13 years 6 months), an orthopedic surgeon performed intraoperative arthrography and measured passive external rotation while the patient received a general anesthetic. The orthopedic surgeon and three radiologists reviewed arthrograms and in consensus classified glenohumeral joints in one of four categories: concentric, with the humeral head well centered on the glenoid fossa; flat, with flattening of the posterior glenoid; biconcave, with the humeral head in articulation with the posterior of two concavities, which were in the same plane; and pseudoglenoid, with the humeral head in articulation with the more posterior of two concavities, with retroversion and in a plane different from that of the anterior concavity. Kruskal-Wallis test was used to compare preoperative external rotation with four appearances of glenoid. RESULTS: Twenty-one children had concentric glenohumeral joints; seven children, flat glenohumeral joints; 19 children, biconcave glenoid; and 17 children, pseudoglenoid. Median passive external rotation was -20 degrees for patients with pseudoglenoid, -10 degrees for those with flat or biconcave glenoids, and 0 degrees for those with concentric glenoids. Presence and type of glenoid deformity were significantly associated with severity of internal rotation contracture (P <.001). CONCLUSION: Consistent patterns of glenohumeral joint deformity in brachial plexus birth palsy were identified and correlated with severity of internal rotation contracture.

Adolescent↗