Contracture and stiffness Discussion
Contractures and stiffness may affect the upper extremity for a variety of
reasons. Regardless of the initial problem, multiple regional structures
are always involved, and treatment requires individual consideration of
skin, tendons, ligaments, joint surfaces as well as imbalance of muscle
forces. Conservative treatment options include stretching exercises,
splinting and other therapy modalities with full patient participation.
Surgical correction may require extensive release of areas far away from
the site of the obvious problem. Established contractures more than three
months old are rarely corrected by therapy alone. Full correction is never
achieved without complete and obsessive patient participation for many
months of therapy. Full correction is rarely, if ever, achieved for
long standing severe contractures. Because corrective surgery for chronic
severe contractures may result in dramatic complications including the need
for amputation, indications are often limited to solving hygiene problems.
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