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At least 1,153 records · Page 64Linked to original sources
PubMed2003

Antineutrophil cytoplasmic autoantibody-negative antiproteinase 3 syndrome presenting as vasculitis, endocarditis, polyneuropathy and Dupuytren's contracture.

Antiproteinase 3 antibodies (antiPR3) are assumed to be subtypes of antineutrophil cytoplasmic autoantibodies (ANCA), with a high specificity for active Wegener's granulomatosis and microscopic polyangiitis. Thus, antiPR3 positivity in ELISA, together with negativity in indirect immunofluorescence (IIF) is a rare finding. A 56-year-old man with Dupuytren's contracture and polyneuropathy was admitted for leukocytoclastic vasculitis. Echocardiography, performed because of fever and dyspnea, detected aortic valve endocarditis. Because of severe aortic insufficiency the valve was replaced. Blood cultures and bacteriologic investigations of the explanted valve were negative. AntiPR3 were elevated (123-163 U/ml; normal <6 U/ml), together with negativity in IIF. This case shows that antiPR3 elevation with negative ANCA may be associated with vasculitis, endocarditis, polyneuropathy and Dupuytren's contracture. A causal relationship between the clinical presentation and antiPR3 elevation is likely. In order not to miss such cases of vasculitis, combined screening by IIF and ELISA is recommended in selected cases.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1992

Anterior capsulotomy and continuous passive motion in the treatment of post-traumatic flexion contracture of the elbow. A prospective study.

Thirty-three patients who had a post-traumatic flexion contracture of the elbow were managed consecutively with anterior capsulotomy without tenotomy of the biceps tendon or myotomy of the brachialis muscle. The first fifteen patients (Group I) did not receive continuous passive motion postoperatively. Preoperative active extension for Group I was to an average of 48 degrees short of full extension, which improved to 19 degrees at a mean follow-up time of forty-five months. Subsequently, eighteen patients (Group II) received continuous passive motion postoperatively for a mean of six weeks. Preoperative active extension for Group II was to an average of 55 degrees short of full extension, which improved to 23 degrees at a mean duration of follow-up of thirty-five months. The mean preoperative arc of motion for Group I was 69 degrees, which improved to 94 degrees postoperatively. The mean preoperative arc of motion for Group II was 48 degrees, which improved to 95 degrees postoperatively. Five patients in Group I and six patients in Group II had severe preoperative heterotopic ossification. There was no correlation, however, between preoperative heterotopic ossification and the amount that extension of the elbow improved postoperatively. There was no postoperative increase in heterotopic ossification. Four patients in Group I and six patients in Group II had severe post-traumatic osteoarthrosis preoperatively. Anterior capsulotomy is an effective treatment of post-traumatic flexion contracture of the elbow. Although the postoperative use of continuous passive motion did not significantly improve mean active extension, it did improve active flexion and the total arc of motion.

Adolescent↗
PubMed1992

[Tendoplasty of the fingers and the restoration of the skin-fatty layer of the dorsal surface of the hand in boutonnière contracture].

In the period from 1983 to 1990 operations were conducted on 63 patients with postburn boutonnière contracture of 116 fingers. In 19 patients (42 fingers) tendoplasty of the extension apparatus of the fingers was carried out with simultaneous restoration of the dermatoadipose layer on the dorsal surface of the hand with an inguinal or dermatoadipose graft. In 39 patients the tendon of the extensor digitorum muscle was injured over several proximal interphalangeal articulations. A new method for treating boutonnière contracture is suggested. It is based on restoration of the continuity of the central fasciculus and the normal position of the lateral fasciculi with a single tendon autograft. The suggested method produced good results in 90% of cases, i.e. in all cases in which a sufficient volume of passive movements at the proximal interphalangeal articulation was restored in the preoperative period.

Adipose Tissue↗
PubMed2003

Measurement of articular cartilage surface irregularity in rat knee contracture.

OBJECTIVE: To design novel quantitative methods to evaluate the irregularity of articular cartilage surface; and to apply these methods for assessment of surface irregularity in a rat knee contracture model. METHODS: A total of 117 rat knees were either immobilized or sham-operated and harvested after 2, 4, 8, 16, or 32 weeks, and 11 knees were not operated. Standardized histologic sections were digitized and the contours of femoral and tibial cartilage surfaces were delineated. The rates of change in cartilage contour were calculated. Rate of change above a defined threshold constituted surface irregularity. RESULTS: In non-operated knees, cartilage surface irregularity in femur and tibia amounted to 3.1 +/- 0.5%. Immobilized knees showed significantly more irregularities than the sham-operated knees at all time points (2 weeks: 5.3 +/- 0.6% vs 3.1 +/- 0.4%; 4 weeks: 10.5 +/- 0.9% vs 4.4 +/- 0.9%; 8 weeks: 12.0 +/- 1.8% vs 4.9 +/- 0.2%; 16 weeks: 13.7 +/- 2.0% vs 4.9 +/- 0.4%; and 32 weeks: 13.8 +/- 1.4% vs 3.4 +/- 0.6%; all p < 0.05). No difference was observed between sham-operated and non-operated knees. Increasing duration of immobilization in weeks (t) significantly correlated with more surface irregularity, described by the logarithmic formula: % irregularity = 6.6 + 2.1 ln (t), (F = 59.3, p < 0.001). This formula showed that irregularity progressed rapidly after immobilization and plateaued after 8 weeks. CONCLUSION: We designed methods to quantify cartilage surface irregularity and applied them to a contracture model. Cartilage surface irregularities appeared after 2 weeks of immobilization and progressed rapidly to plateau after 8 weeks. Combined with microscopic magnetic resonance imaging, this measurement of cartilage surface irregularity may constitute a sensitive tool to detect cartilage degeneration clinically.

Animals↗
PubMed2004

[Reconstruction of the mentum in the surgical management of cervical scar contracture].

OBJECTIVE: To investigate the effects of the reconstruction of the mentum with cervical tissue flaps in the surgical management of postburn cervical scar contracture. METHODS: Thirteen postburn patients with severe cervical scar contracture and mental deformity were enrolled in the study. The platysma flap (3 cases), scar tissue flap (6 cases) and cervical deep fascia tissue flap (3 cases), with the pedicle containing the facial and the superior thyroidal artery, were turned upwards to replenish mental soft tissue, and to form new mentum and sulcus mentolabialis. The cervical scars were repaired with expanded flap (11 cases), free flap (1 case) or trapezius muscular flap. RESULTS: The post-operative cervical configuration was found to be good, and the tissue flaps for mental reconstruction healed satisfactorily. Ten patients were followed-up for 6 to 24 months. All flaps were successful and achieved good results, except that scar formation was found in the cervical linear incision in 4 patients. CONCLUSION: Transfer of the platysma flaps, scar tissue flaps, or deep cervical fascial flaps for the reconstruction of cervical scar were simple and effective. The use of cervical scar tissue flaps could not only loose the constructed scar, but also beneficial in rectifying the configuration of the chin.

Adolescent↗
PubMed2004

Treatment for flexion contracture of the knee during Ilizarov reconstruction of tibia with passive knee extension splint.

Joint stiffness is one of the complications of limb procedure. It developes as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the affected joint. We are reporting four patients who developed fixed flexion contracture of their knees during bone lengthening procedure for the tibia with Ilizarov external fixator. Three of them were treated for congenital pseudoarthrosis and one was for fibular hemimelia. None of them were able to visit the physiotherapist even on a weekly basis. A splint was constructed from components of Ilizarov external fixator and applied on to the existing frame to passively extend the affected knee. Patients and their family members were taught to perform this exercise regularly and eventually near complete correction were achieved. With this result, we would like to recommend the use of this "Passive Knee Extension Splint" to avoid knee flexion Contracture during limb lengthening procedures with Ilizarov external fixators.

Bone Lengthening↗
PubMed1992

[Use of a distraction apparatus in the treatment of flexion contractures in the interphalangeal joints].

The use of a Volkov-Oganesjan distraction reposition apparatus in the treatment of flexion contractures of interphalangeal joints gives very satisfactory results. As compared with formerly used methods of conservative treatment, the apparatus makes reposition of the contractures possible, by its design it protects articular cartilages against damage by pressure and makes continuous rehabilitation of the joint possible throughout the period when the apparatus is used.

Adult↗
PubMed2005

[Preventive effect of chitosan on capsular contracture after implantation of silicone gel-filled mammary implants in rats].

OBJECTIVE: To study the preventive effect of chitosan on capsular contracture after implantation of silicone gel-filled mammary implants in rats. METHODS: 18 SD female rats were divided into three groups randomly. Small silicone gel-filled mammary implants were implanted under each side of latissimus dorsi muscle. Chitosan was injected into left cavities as experimental sides, and nothing was injected into right cavities as control sides. 4, 8 and 12 weeks postoperation, specimens were dissected and observed using light microscope, and area density of collagen both type I and type III were also detected. RESULTS: Fibrous capsules around implants consist of two layers: dense layer and loose layer. 4 weeks postoperation, total thickness of the experimental sides was less than that of the control sides (P < 0.01). Area density of collagen either type I or type III of the experimental sides was lower than that of the control sides (P < 0.01). Both 8 and 12 weeks postoperation, total thickness of the experimental sides was less than that of the control sides (P < 0.05). Area density of collagen type I of the experimental sides was lower than that of the control sides (P < 0.05). Area density of collagen type III was of no statistical difference between the experimental sides and the control sides (P > 0.05). CONCLUSIONS: Chitosan can remarkably prevent capsule contracture during the early period after implantation of silicone gel-filled mammary implants.

Animals↗
PubMed1992

[Early-onset benign autosomal dominant limb-girdle myopathy with contractures (Bethlem myopathy) in a Japanese family].

We report a family showing an early-onset benign autosomal dominant limb-girdle myopathy with contractures. The clinical features in our family included; 1) slowly progressive limb-girdle muscle weakness since childhood. 2) contractures of fingers, elbows and ankles, 3) mild motor impairment with preserved activities of daily living. The disease was inherited through an autosomal dominant trait. Muscle pathology revealed variation in fiber size, slightly increased central nuclei, mild endomysial fibrosis, type 1 fiber predominance and type 2 fiber atrophy. The above clinical features were similar to those seen in patients reported by Bethlem (1976) and Mohire (1988), and therefore we made a diagnosis of Bethlem myopathy on this familial patients which was extremely rare in Japan.

Ankle↗
PubMed1992

Release of the subscapularis for internal rotation contracture and pain after anterior repair for recurrent anterior dislocation of the shoulder.

Ten patients who had an internal rotation contracture and pain after an anterior repair for recurrent dislocation of the shoulder were treated by release of the subscapularis muscle. For six of the patients, radiographs demonstrated severe osteoarthrotic changes in the shoulder as well. The release was done an average of eleven years after the original procedure, which, for most patients, had been a Putti-Platt repair. After release of the subscapularis, each patient had less pain in the shoulder and an average increase of 27 degrees of external rotation. Release of the subscapularis can offer relief of pain and of functional limitations associated with the symptoms caused by an internal rotation contracture after an anterior repair of the shoulder.

Adult↗
PubMed2006

[Bladder contracture following intravesical BCG immunotherapy treated by hydrodistention: a case report].

A 35-year-old man had undergone retroperitoneoscopic radical nephrouretectomy in May 2002 (pTisNxM0). He later developed carcinoma in situ (CIS) of the bladder, and underwent intravesical instillation of 80 mg of Bacillus-Calmette-Guerin (BCG) once a week for 6 weeks in January 2004. After the treatment, irritative symptoms (frequency and dysuria) developed, and he was diagnosed with bladder contracture. Conventional treatment with anti-cholinergics, analgesics, anti-tuberculous drugs, and steroids was ineffecsive, but hydrodistention improved the subjective symptoms. Hydrodistention seems to be useful for bladder contracture following intravesical BCG immunotherapy.

Administration, Intravesical↗
PubMed2006

Posttraumatic contracture of the elbow: current management issues.

Posttraumatic elbow stiffness can impose severe functional limitations on the performance of activities of daily living. Prevention is key to avoiding a motion-limiting condition. Fractures should be anatomically reduced and stabilized with active and active-assisted range of motion exercises instituted as early as possible to minimize the development of stiffness. Established contractures should be treated initially with physical therapy and static-progressive splinting. Patients who have failed a minimum of six months of nonsurgical management and who are motivated to comply with postoperative rehabilitation are candidates for surgical release. There are several effective surgical approaches and techniques available. The choice of surgical approach and technique is dictated by the location of the pathology, condition of the skin, and degree of arthritic changes. A major challenge to care is the management of the young patient with posttraumatic elbow contracture and advanced degenerative changes for which there is currently no reliable long-term surgical treatment.

Arthroscopy↗
PubMed1991

Relationship between electromyographic activity of the vastus lateralis while standing and the extent of bilateral simulated knee-flexion contractures.

The effect of simulated bilateral knee-flexion contractures (KFC) on the electromyographic (EMG) activity of the vastus lateralis was studied by testing 10 normal subjects using surface EMG to test the hypothesis that the activity of the knee extensors would increase as a function of the severity of the contracture. The root mean square of the EMG activity was determined from four 4-s samples taken at 30-s intervals, during 2 min of standing in each of five positions of simulated KFC (0 degree, 10 degrees, 20 degrees, 30 degrees and 40 degrees). A randomly balanced order of conditions was used. KFC were simulated in each subject by means of an adjustable line from the subject's waist to the sole of each foot. An analysis of variance was used to contrast EMG activity, and a significant difference was found between each of the positions (P less than 0.05). The mean (+/- 1 SD) EMG activity, expressed as a percentage of the maximum voluntary contraction, was 0.3% (+/- 0.2) at 0 degree, 7.6% (+/- 5.6) at 10 degrees, 10.9% (+/- 7.6) at 20 degrees, 16.6% (+/- 12.4) at 30 degrees and 24.0% (+/- 14.0) at 40 degrees. A linear relationship was found (r2 = 0.986), expressed by the equation y = 0.62 + 0.56 x, where y represents EMG activity and x represents the extent of simulated KFC (P = 0.0007). The results provide insight into the increased knee extensor activity necessary to stand with KFC and underline the importance of treating this common disorder.

Adult↗
PubMed1991

Some medicolegal aspects of Dupuytren's contracture.

This article presents the medical and legal aspects of Dupuytren's contracture. It also presents a rational basis for the assessment of the relationship, if any, between a patient's occupation and the development of Dupuytren's contracture.

Australia↗
PubMed1991

Dupuytren's contracture in women.

Dupuytren's contracture in women is similar to that in men. A limited fasciectomy is the operative procedure of choice for women with Dupuytren's contracture. The most significant difference between men and women is the higher incidence of a flare reaction in women following the operation. This must be considered when contemplating such procedures because the flare is associated with a greater risk of residual joint stiffness.

Adult↗
PubMed1991

Congenital contractural arachnodactyly in a black African kindred.

Congenital Contractural Arachnodactyly is an inherited disorder of connective tissue characterised by congenital contractures, arachnodactyly, marfanoid habitus, crumpled auricles and in some kindreds, progressive kyphoscoliosis. An extensive kindred with many affected members is described. The importance of the early recognition of this syndrome is highlighted.

Abnormalities, Multiple↗
PubMed1991

[Musculocutaneous flaps for repair of scar contracture of neck].

Twenty-four cases of scar contracture of neck were repaired with musculocutaneous flaps. Latissimus dorsi musculocutaneous flap was used in 21 cases, latissimus dorsi-serratus anterior musculocutaneous flap in 2, and lower trapezius musculocutaneous flap in 1. All the flaps were alive with satisfactory functional results and shape. This simple method is also suitable for patients with scar contracture of armpit, anterior chest and lower lip.

Adolescent↗