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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