Contracture

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at September 26, 2016
Start › Diseases › Contracture

Contractures or contracture deformities affect many people, and it takes some time to properly diagnose and treat this ailment. It is important to understand what contractures are so that they can be dealt with. 

Contents

Definition & Facts

There are many different types of contractures, including the following:

Muscle contractures can be easily defined as a shortened muscle or joint. There are many reasons why this may happen, such as long-term immobility.

A burn scar contracture occurs during the healing process of a second degree burn or third degree burn. The skin could tighten as it heals, which could end up reducing mobility. This is especially true if the patient does not apply silicone gel or do any kind of physical therapy.

The capsular contracture is an immune system response to a foreign object in the body. This could be anything from an artificial cardiac pacemaker to breast implants. It is a medical complication where collagen capsules tighten up around the foreign object.

The Dupuytren's contracture or palmar fibromatosis, is a flexion contracture that happens right on the palm of the hand. This condition causing one of the fingers to bend towards the palm. A patient with this disease will not be able to extend the affected finger afterwards.

Symptoms & Complaints

There are many symptoms associated with all types of contractures. For example, lumpiness or hardness around the fingers is usually associated with Dupuytren's contracture. A woman's implant might not feel supple after a month of the surgery, or the breast implant might implode, making the breast look like a deflated balloon.

For burn contractures, one might notice lumps and stiffness around the area of the injury. The hardest contracture to diagnose early is perhaps the muscle contracture, though muscle stiffness and joint pain are possible. Doctors notice an issue like this when patients visit the doctor frequently. The doctor will be able to see any sudden changes in the patient's body. 

Causes

There are many reasons why a contracture could occur. The simplest and most common is the burn contracture. The burn that is most associated with this issue is the third degree burn. The burn is so severe that it kills a significant amount of skin cells. The skin heals, but there is a complication in the process. Skin cells simply do not regain the elasticity that they once enjoyed, making it a lot harder to achieve the mobility the patient is used to.

A muscle contracture can come about due to a neurological disorder like cerebral palsy. The brain is unable to control certain muscles, which leads to spasticity and injury. Of course, this is just one of the reasons why someone might get this type of contracture.

The capsular contracture is a problem that usually happens to people who get breast implants. Dupuytren's contracture is uncommon and its precise causes are not really known. What is known is that it is usually associated with people with diabetes mellitus, seizure disorders, and those suffering from alcoholism.

Diagnosis & Tests

Diagnosing these issues is all about visiting a specialist at the right time should one be suspicious. The doctor will simply examine the hands looking for lumps or nodules. The patient's grip will be tested to see how strong it is. The doctor might also take a few measurements so that he or she can see the progression of the disease.

The capsular contracture is usually felt by the patient. Hardness builds up around the implanted foreign object. The hardness is what the doctor uses to help diagnose if a possible complication with the implant might be occurring.

There are several things that a doctor can use to examine a possible muscle contracture such as elastosonography, though this method is not always used. It uses ultrasonography to examine the stiffness of tissues. Detecting a burn contracture also involves the doctor testing the elasticity around the affected area. 

Treatment & Therapy

Dupuytren's contracture does not have a cure, but that does not mean that it cannot be treated. There are several treatment options such as a corticosteroid injection. This treatment does not involve a surgical solution and usually helps keep the hand in working condition. Of course, those with severe issues might need surgery, but that is best discussed with a doctor.

Muscle contractures are often treated through physical therapy with a physiotherapist who targets specific muscles in an attempt to revitalize that particular area and restore elasticity. This treatment is long-term and its focus is to improve mobility.

Capsular contractures are usually treated with surgery where the capsule creating the issue is treated and reduced. It is at this point that the patient might be able to overcome this particular complication. Burn contractures may also need surgery should collagen and ointment treatment prove noneffective. 

Prevention & Prophylaxis 

Muscle contractures can be prevented with stretching exercises like yoga or tai chi. There is not much that can be done to prevent Dupuytren's contracture except avoiding drinking and smoking and trying to prevent diabetes. One can do this by opting for a healthy diet, such as eliminating processed foods and eating more organic fruits and vegetables.

Preventing a burn-related contracture is all about ensuring that one is safe from a fire. Making sure that all fire alarms are functioning in one's home or office is important. The capsular contracture may be avoided should doctors take the right precautions before surgery like disinfecting the area being operated.

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