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Contracture treatment can range from exercise to surgical removal of affected tissue. Therapy or treatment varies with the type and location of the contracture. The malady may occur because of extended immobility, injury, or from certain hereditary conditions.
A muscle or joint contracture occurs when soft tissue surrounding the joint shortens and tightens, resulting in limited movement. Elbow contracture treatment may begin with heat applications, which assist tissue relaxation. Therapists may use passive range of motion exercises with increasing amounts of tension in an attempt to extend the arm. Splints to maintain full extension may be specially designed for individual patients. In severe cases, surgeons perform arthroscopic surgery to release tightened tissue.
Knee contracture treatment proceeds in a similar fashion. Massage and heat help relax the underlying tissue after which passive range of motion slowly extends the limb. Physical therapists may also use continuous passive motion machines, which extend the knees and improve range of motion. Under certain circumstances, physicians may inject botulinum toxin directly into affected muscles. The toxin inhibits the release of acetylcholine, allowing the connective tissue and muscle to relax, and patients may receive injections every eight to 12 weeks as needed.
Capsular contractures typically occur after breast augmentation surgery when implants are inserted above muscle tissue. The tissue area on top of the implant may become inflamed and hardened. Depending on the severity of the condition, physicians might prescribe anti-inflammatory medications, such as zafirlukast. Antibiotics may be prescribed if the condition is a result of infection. Massage, ultrasound, or surgery may also be used to break up or remove affected tissue.
Dupuytren’s contractures usually affect the palmar side of the hands but may also affect the feet. The condition is frequently hereditary but is also seen in patients with diabetes mellitus, seizure disorders, or a history of alcohol abuse. The fascia underneath the skin, which covers the muscles and tendons affecting movement, thickens, shortens, and becomes taut. As the disease progresses, the skin appears dimpled. The fingers eventually draw inward as the fascia nodules pull and constrict the muscles and tendons.
Contracture treatment in this instance may involve stretching, heat, and ultrasound to relax tissues in the early stages of the disease. Cortisone injections typically minimize inflammation, and physicians may break up thickened nodule cords with a procedure known as needle aponeurotomy. Individuals suffering severe cases may undergo surgery to remove abnormal fascia.
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