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What Is a Flexion Contracture?

In some cases, tailored physical therapy can effectively treat a painful flexion contracture.
Some flexion contractures affect the knee.
Those with flexion contractures may find it difficult to stand or walk without assistance.
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  • Written By: Mary McMahon
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 18 December 2014
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    Conjecture Corporation
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A flexion contracture is a shortening of muscle tissues and tendons, forcing a joint into a flexed position and holding it there. A patient with this condition will have limited range of movement in the affected joint and may not be able to fully straighten it. This can cause discomfort and may make it difficult to complete daily tasks. It can also lead to additional injuries, as patients may adapt to the flexion contracture in ways that strain neighboring bones and joints.

Causes for this condition can vary. Sometimes it is the result of atrophy, a common problem for people with paralysis because they cannot move their limbs independently. Severe scarring from burns, surgeries, or serious injuries can create a flexion contracture by making it impossible to fully extend the joint, leading to atrophy over time. Fractures to neighboring bones and injuries to the nerves can also result in a flexion contracture.

The onset of the problem is usually gradual. A patient might notice problems with moving the joint at first, with increasing stiffness over time. Eventually, the patient will be unable to fully straighten the joint, and the range of movement may be more limited over time. Common sites for this joint problem are the elbow, wrist, and knee. For example, Volkmann's contracture is a condition involving the wrist that forces the patient's hand and fingers into a flexed, claw-like position.

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Treating a flexion contracture requires finding out why the patient has the condition and providing appropriate interventions. Physical therapy to mobilize and loosen soft tissue is one option. The patient may need massage, gentle stretching, and other services. In some cases, surgery is necessary to cut through bands of scar tissue. After surgery, the patient will need more physical therapy to prevent scars from forming again.

There are some measures people can take to prevent this condition. Patients with limited mobility, including people with paralysis and individuals who spend a lot of time in bed, need some form of exercise to prevent contractures. Nurses, home health care providers, and physical therapists can all participate in moving patients through a series of stretches to prevent muscle atrophy and keep the patient more comfortable. In the case of patients with injuries that may scar, using physical therapy and stretching to prevent scar formation and retain mobility is important, even if it is painful. Doctors may also recommend tools like compression bandages to limit scarring and prevent flexion contractures.

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