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PubMedDate not supplied

Proximal tibial extension medial rotation osteotomy to correct knee flexion contracture and lateral rotation deformity of tibia after polio.

A proximal tibial extension medial rotation osteotomy was performed on 17 tibias in postpoliomyelitis patients to correct knee flexion contractures simultaneously with the correction of lateral rotation deformity of the tibia through the same osteotomy. Gait improved in 10 patients. Five patients developed recurrence of knee flexion contractures; five more developed greater than 20 degrees genu recurvatum. One patient developed a common peroneal nerve palsy. Because of the high incidence of complications, we recommend that this procedure be abandoned.

Adolescent↗
PubMed1990

[Clinical aspects and surgical treatment of Dupuytren contracture].

The etiology of Dupuytren's contracture is still not clear. Many theories have been proposed, but no basic data are currently available that would make it possible to treat Dupuytren's contracture by other methods than surgical intervention. The surgical technique used in our clinic is described, and a postoperative treatment is also outlined. This paper is designed to propose an acceptable technique for practicing trauma and hand surgeons.

Dupuytren Contracture↗
PubMed1990

The Judet quadricepsplasty for management of severe posttraumatic extension contracture of the knee. A report of a bilateral case and review of the literature.

Extension contracture of the knee is an increasingly recognized complication of severe femur fracture. Traditional management by Thompson quadricepsplasty may result in a variable return of knee flexion and the possibility of significant extension lag. The Judet technique of quadricepsplasty offers the advantages of a controlled, sequential release of the components limiting knee flexion and a reduced potential for iatrogenic quadriceps rupture or extension lag. Judet quadricepsplasty corrected severe bilateral extension contractures with excellent results at 17 months postoperatively in a 29-year-old man.

Accidents, Traffic↗
PubMed1990

[Prevention of decubitus, edema, contractures].

This paper presents a historical reminder of the development of medical care, a contemporary consideration of the division of care, as well as the definition of the term-quality medical care, and a review of the preventive measures for bed-sore, edema and contracture. In regard to the fact that care and therapy are a tightly bound process, they must also be applied as such. The definition of the term-quality medical care is an open question. The prevention of bed-sore, edema and contracture is the element of quality care.

Contracture↗
PubMed1990

The lateral approach for operative release of post-traumatic contracture of the elbow.

A lateral approach was used to release a post-traumatic contracture of the elbow in seven patients, and the results were evaluated an average of thirty-eight months postoperatively. Extension improved from an average flexion contracture of 45 degrees preoperatively to one of 12 degrees postoperatively, and the average point of maximum flexion increased from 116 degrees preoperatively to 129 degrees postoperatively. The average arc of motion increased 46 degrees. All patients began using a continuous-passive-motion device immediately after the operation. There were no problems with wound-healing or formation of heterotopic bone.

Adolescent↗
PubMed1990

Contracture of the shoulder.

A retrospective study involving 2027 patients with a limited range of motion of the shoulder in the period from 1970 to 1987 is described. Of these, 1219 patients (60%) were diagnosed as having frozen shoulder, with the highest incidence occurring in patients aged 50-60 years. The mechanism involved in the contracture is complicated. At first, the movement of the greater tuberosity at the subacromial level (also called the subacromial secondary joint) is limited due to bursitis. The external rotation of the upper arm then decreases, and the long rotator muscles contract. The relationship between the cause of contracture and the direction of the decreased mobility was analyzed. A ratio of the degree of external rotation with the arm beside the body to that achieved with the arm elevated to the horizontal plane showed values of almost one to one. Conservative treatment including physiotherapy, local anesthetic block, and joint distension must be attempted in all patients. If the conservative treatment remains ineffective, the surgical procedure should be considered. Satisfactory clinical results of arthroplasty of the subacromial joint were obtained in patients with frozen shoulder.

Adolescent↗
PubMed1989

New facts about the pathogenesis of Dupuytren's contracture.

A histotopographical study is presented of the innervation of the palmar aponeurosis in human embryos and foetuses of both sexes and in adults. Beginning with the 4.5 to 5th months of embryonic development and later on in adults, too, the ulnar margin of the distal part of palmar aponeurosis (i.e., tendons of digits 4 and 5 most likely to be affected by Dupuytren's contracture) is the most abundantly equipped with encapsulated receptors of the type of Vater-Pacini corpuscles. With reference to a study of the microcirculation of palmar aponeurosis proprioreceptors in the norm and to the histophysiology of Vater-Pacini corpuscles in the norm and in Dupuytren's contracture the author presents the view that primary impairment of microcirculation in the proprioreceptors of palmar aponeurosis due to a variety of causes is part of the basic pathogenesis of the condition.

Adult↗
PubMed1989

[Late results of Eggers' operation in spastic contracture of the knee].

Authors assess the late results of flexor tendon transplantation in spastic flexion contracture of the knee on the basis of the follow-up of 29 cases. It is stated that the method is suitable to eliminate the flexion contracture, however it is unable to cease the gait disturbance of the basic disease, as after the Eggers' operation patients walk characteristically with extended knees and a compensating increased lumbar lordosis. These unfavourable effects may be diminished by an individually planned, selective muscle transplantation performed after a careful preoperative clinical examination, motion analysis, perhaps also after an electromyographic examination.

Animals↗
PubMed1989

[Reconstructive surgery in post-traumatic contractures of the knee joint].

214 patients with posttraumatic contractures of the knee joint were treated at the Leningrad Research Institute of Orthopaedics and Traumatology in 1970-1985. In 67 patients the Thompson-Kaplan operation was performed. Since 1980 an operation worked out at the Institute has been made in 194 patients. Their treatment results were much better, especially in the patients with the most severe contractures of the knee joint which developed after diaphyseal and intraarticular fractures of the femur as well as after preceding osteomyelitis or purulent gonitis.

Adult↗
PubMed1989

Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment.

Seventeen patients who had recalcitrant chronic adhesive capsulitis were operated on between 1979 and 1986 and were followed for an average of 6.8 years. At operation, the major cause of the restricted glenohumeral movement was found to be contracture of the coracohumeral ligament and rotator interval. Release of the contracted structures relieved pain and restored motion of the shoulder in all patients. Histological study showed fibrosis, hyalinization, and fibrinoid degeneration in the contracted connective tissues, as well as fibrosis of the subsynovial tissue and an absence of the synovial cell layer on the joint side of the rotator interval. The contracture of the coracohumeral ligament and rotator interval appears to be the main lesion in chronic adhesive capsulitis. Resection of these structures, combined with appropriate exercise, will relieve pain and restore motion to the shoulder.

Adult↗
PubMed1989

[Treatment of elbow contracture].

The most common sequela of the elbow joint after injury is decreased range of motion, i.e. elbow contracture. From January 1986 to July 1987, the Orthopaedic department of Kaohsiung Medical College collected data of 10 elbow contracture on 9 cases. Treatment included capsulotomy and joint debridement with immediate postoperative rehabilitation. This paper reports the clinical follow up results with an average time of 7 months after the operation. Range of motion increased 50 degrees on the average. No residual pain was complained. Activity of daily living was improved and the results were satisfied.

Adolescent↗
PubMedDate not supplied

Dantrolene sodium in traumatic muscle contracture: double-blind clinical and pharmacological trial.

Thirty athletes with muscular contractures were enrolled in a double-blind study of dantrolene sodium and placebo to evaluate the decontracture activity and tolerance of the drug after eight days of treatment. The efficacy of the drug was assessed by studying pain at rest, during movement, and during pressure, as well as muscular tension and functional recovery. Twenty-eight patients completed the study. At the end of treatment, a decrease in pain was observed at rest (71.4% of patients treated with dantrolene and 21.4% of placebo-treated patients), during movement (78.6% and 35.7%, respectively), and during compression. The most noticeable effects were seen in the reduction of muscular tension (100% in the patients treated with dantrolene sodium and 35.7% in the placebo-treated patients) and in functional recovery (100% and 28%, respectively). In addition to the clinical study, an evaluation of the effects of dantrolene and placebo on overall performance and on the action of the respiratory system was conducted with six healthy subjects by means of basal respiratory measurement and ergospirometry before and after single-dose treatment. This study showed that dantrolene sodium is useful in the treatment of traumatic contracture, and that it does not alter an individual's overall performance. Dantrolene sodium represents a valid treatment to accompany analgesic, anti-inflammatory, and rehabilitation therapy of posttraumatic lesions in athletes.

Adolescent↗
PubMed1989

[Pathomechanogenesis of contractures and deformities of the upper extremities in children with cerebral palsy].

The authors carried out dynamic observation of 180 children aged 3-14 with infantile cerebral paralysis (ICP) who were treated for pronation flexion contractures of the forearm and of the hand, studied up to 45 values connected with the age of the patients, terms of appearance of the symptoms of the disease, subsequently processed the results of their investigations employing methods of analysis of variance, non-linear correlation and regression analysis and constructed analytical models of development of the pathologic process, which allowed to draw the following conclusions. Pathomechanogenesis of disturbances of the upper extremity in ICP includes primary muscular disbalance, successive formation of faulty postures, pathologic locomotor stereotype, vegetotrophic disturbances, contractures of the joint and anatomical changes of the skeleton. These changes are closely correlated with the age of the patients and according to the degree of the disturbances may be regarded as stages of the disease.

Adolescent↗
PubMed1989

[Treatment of adduction cicatricial contracture of the thumb].

The authors discuss the results of treatment of 56 patients with adduction cicatricial contractures of the thumb which developed after severe mechanical, gunshot and thermal injuries. According to the degree of the deformity, 3 degrees of contractures are distinguished and each cells for certain therapeutic tactics. Various types of free and pedicle dermatoplasty and a method of dosed distraction by means of apparatuses designed in the clinic were employed. Among 40 patients who were examined 35 showed good functional and cosmetic results.

Adult↗
PubMed1989

[Use of surgical flaps for plastic surgery in posterior adduction cicatricial contracture of the thumb].

Methods of flap and combined plastics in dorsal adduction cicatricial contracture of the thumb are discussed. Different variants of plastics are substantiated on the basis of study of the anatomical features of the contracture. The formation of a commissure by a trapeziform flap of skin and fatty tissue of the palmar layer and palm is the foundation of the operation. Depending on the degree of deficiency of the cicatricial layer of the fold in the first interdigital space, the wounds to the sides of the main flap are closed with local tissues or by free dermatoplasty. The operative methods were approved in more than 200 patients and good functional and cosmetic results were produced in all of them.

Cicatrix↗
PubMed1985

Isolated facial myokymia and facial contracture: computed tomography and magnetic resonance imaging correlation.

Isolated facial myokymia with contracture can be the earliest manifestation of intrinsic lesions of the brainstem. We report a case of facial myokymia with contracture occurring as the result of a pontine glioma, as depicted on cranial computed tomography and magnetic resonance imaging studies. The rostral location of the tumor supports the supranuclear disinhibition hypothesis of facial myokymia.

Adult↗
PubMed1986

Muscular contracture as a component of low back pain: evaluation criteria and significance of relaxant therapy.

The measurement of diastasis of the spinous processes and of muscular action potentials by means of bio-feedback equipment is a clinically valid means to evaluate the extent of reflex muscular contracture. The methods were used to study the relaxant effect of pridinol mesylate on the lumbar extensor muscles in subjects with acute low back pain. It was found that pridinol mesylate significantly reduced the contracture of the extensor lumbar muscles in low back pain when given per os or parenterally.

Action Potentials↗