Kontraktur

dr Yuda Handaya, SpB,FInaCs,FMAS

Contractures are the chronic loss of joint motion
structural changes in non-bony tissue
These non-bony tissues include muscles, ligaments, and tendons.

C an occur at any joint of the body
This joint dysfunction may be a result of :
immobilization from injury or disease
nerve injury ( spinal cord damage & stroke )
or muscle, tendon, or ligament disease.

Contractures may be caused by abnormalities of the structures surrounding a joint. These include:
Deformity
Immobility
Injury
Chronic inflammation
Certain disorders that affect nerves and muscles almost always lead to contractures. For example:
Muscular dystrophy
Cerebral palsy
Contractures are often also associated with spasticity resulting from injuries to the central nervous system.

Manual testing of joint mobility
Measuring the motion of the joint with a device termed a "goniometer“
X rays
physical examination involving physical and manual testing of the joint motion

A risk factor is something that increases your chances of getting a disease or condition.
Each of these conditions increases the risk for contractures:
Rheumatoid arthritis
Tenosynovitis (inflammation of a tendon and its sheath)
Polio and other diseases of nerves and muscles
Trauma
Burns
Scarring
Prolonged inactivity

The primary symptom
is loss of motion in a joint.
Pain can also be a major symptom

Manual techniques
Joint mobilization and stretching of soft tissues
Mechanical techniques
continuous passive motion machines
following surgery of joints.
administered within the first 24-72 hours after the injury or surgery.
The joint is mechanically moved through the patient's tolerable motion.
CPM machines have been proved to accelerate the return motion process, allowing patients more function in less time.

Casting or splinting
used to provide a constant stretch to the soft tissues surrounding a joint.
initial holding cast is applied for seven to 10 days, a series of positional casts are applied at weekly intervals.
Surgery
manipulation of the joint under a general anesthesia
Alternative treatment
Massage therapy can be beneficial by promoting additional circulation to joint structures, causing better elasticity.
Yoga can help prevent as well as rehabilitate a contracture and can facilitate the return of joint mobility.

Prevention of contractures depends on the cause. After acute injuries or orthopedic surgery, contractures may be prevented by:
Early movement
Physical therapy
Continuous passive motion (CPM) machines, which mechanically keep joints in motion
Aggressive medical treatment of inflammatory conditions such as rheumatoid arthritis may also delay or prevent contractures.

Prognosis
D epend upon the cause of the contracture.
In general, the earlier the treatment for the contracture begins, the better the prognosis.
Prevention
program of positioning, splinting if appropriate, and range-of-motion exercises either manually or mechanically aided.
These activities should be started as early as possible for optimal results.

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Kontraktur

by Yuda Handaya on Jun 02, 2010

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Kontraktur — Presentation Transcript