Treatment and development of contracture of the knee joint

knee contracture In the treatment of limb fractures, temporary therapeutic immobilization is carried out: skeletal traction, plaster dressing, osteosynthesis.

Immobilization is performed in order to create conditions for the consolidation of bone parts. However, due to immobility, complications occur.

Thus, very often after fractures of the legs, contractures of the knee joints can be observed.

It is the immobility of the foot in this period, mainly, which causes the appearance of contractures.

Therefore, when restoring patients with leg injuries, one of the main tasks is to combat this phenomenon.

Article Contents

The reasons that may be contracture
Types contractures
- extensor and flexor pathologies
Symptoms occurrence
treatment and the development of knee contractures
- Surgery
Consequences and complications
Conclusions

The reasons that may be contracture

contracture can beis caused by different reasons.

The onset of the disorder can be inflammation, trauma, changes in the joint bones due to arthritis or arthrosis, loss of ligament elasticity, muscle shortening. An "arthrogenic" contracture appears due to a dislocation inside or near the joint, fracture of bone, stretching or bruising.

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People with joint diseases suffer from this disorder, but sometimes it can also occur in healthy joints.

Knee contracture is not a disease - it is the result of a transferred illness, an injury or a congenital deviation .

Almost any serious injury entails this problem. A scar is formed on the affected tissue. It is not elastic, and therefore interferes with the normal operation of the joint.

The defeat of different severity appears with any damage to the musculoskeletal system. Such disorders as arthrosis and arthritis can also cause pathology.

It can occur due to damage to the nervous system. But often the nature of joint damage is mechanical.

Restoration after any injury to a damaged place requires rest.

But the longer the affected area is at rest, the higher the risk of contracture and the harder it is to get rid of it.

Types of contractures

The joint can be combined:

with extension;
when bending;
when cast;
with lead;
when rotating.

Extensor and flexor types of pathology

The main types of violations - flexion( bending violation) and extensor( violation of extension);restrictions and other movements - rotational, lateral.

Symptoms of occurrence

The main manifestation is the restriction of flexion or extension. Basically, there is a pronounced deformation of the joint.

The following symptoms may occur:

edema;
bearing break;
joint pain;
shortening and uncomfortable leg position.

Otherwise, the manifestations depend on the provoking disease. With the continued existence of contracture, the symptoms of knee arthrosis are routinely identified.

To measure the severity of the contracture, measurements of the volume of movements are made.

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Treatment and development of the knee with contracture

Doctors pursue the goal - to eliminate inflammation, pain and restore joint mobility. Current medicine has made some progress in this. medication in the knee

The prognosis fully depends on the type and extent of the lesion, on the amount of time from the moment of appearance, on the patient's age and condition, on the time from which the treatment started.

The earlier to proceed to it - the higher the probability of positive dynamics, and in the end - the absolute cure.

To date, conservative and surgical treatment of the disorder is used.

For joint development using conservative treatment:

physical training;
therapeutic massage;
physiotherapy;
shock wave therapy;
electrophoresis;
manual therapy;
thermal procedures;
medicinal treatment.

Of the drugs used hormones and painkillers( novocaine, lidocaine).They are injected into the aching joint, the pain recedes, because of this the muscles again acquire a healthy tone, and the process slows down significantly.

While performing massage with restriction of knee mobility, it is necessary to actively influence weak muscles and carefully - on the muscles-antagonists. Exercise with caution. First, quiet movements, then - active.

Only after some period of time are elements of resistance introduced. There are a number of fairly effective exercises:

alternately bend your knees, pulling to the stomach;
raise a bent leg, then straighten, lowering to the floor;
perform one foot of movement, similar to biking, then change foot;
flexing feet and straightening up;
to implement foot traffic like a bicycle;
raise a straight leg;
bend the leg in the knee, keeping it on the weight;
then carry out circular rotation of the shin;
put a straight foot on the gym ball and put pressure on it;
bend legs with the ball between them;
position the limbs on the ball, roll it from yourself and towards yourself, trying to pull your legs;
placing the ball under the knees, press on it with heels;
squeeze the ball between the thigh and lower leg and lift it up;
to carry out cycling by foot, lying on its side;
lying on its side, raise the bent leg and straighten it, executing the swing upwards;
in the same position to lift a leg, keeping it on weight;
alternately bend your knees, lying on your stomach;
lying on the stomach, bending both legs;
in the same position to lift a straight leg;
and, again on the belly, bend the knee;
then - rotation of the shin in a circle;
on the abdomen - to take a straight leg out of the way.

All exercises are performed 10 times. Do it regularly - three times a week, and better - every day. But certainly under the control of the doctor.

Thermal baths are also used, starting from 36 degrees, with time connected paraffin and mud.

Conservative methods in the complex are aimed at restoring normal mobility and limb performance.

physiotherapy with contractures When used, the disease is not burdened by complications, pain is neutralized, the joint becomes mobile, muscles are strengthened, the joint receives nutrients.

Blood flow is restored, stagnant processes stop, spikes pass. At the stage of recovery, mechanotherapy is used, combining therapeutic, restoring exercises with the use of special instruments and simulators.

Surgery

If the contracture is not treated with conservative methods, surgery is performed.

Through it, scars are removed, muscle length, tendons restored, they are released from the scars, they perform transplantation, osteotomy, etc.

In case the tendon is significantly damaged, use canned or made of special fabric material.

Various corrective operations of bone tissue can be performed.

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Consequences and complications of

Without timely competent treatment, contracture of the joint leads to its immobility. The disease at this stage is treated only surgically, so at the first signs it is necessary to contact a specialist.

A defeated defeat does not allow the patient to move normally and causes deformity of the limb, not allowing a person to live normally and reducing his physical activity to a minimum.

Conclusions

Thus, subject to regular training, physiotherapy exercises with contracture of the knee joint will help the patient's joint to restore work and will subsequently foster its strengthening.

The prognosis depends significantly on the underlying disorder, the severity of changes in the joint and a number of located tissues. Fresh contractures with proper treatment and regular sessions of therapeutic gymnastics are, in general, well suited to conservative treatment.

When the process is running, the forecast is less positive, becausewith time, changes in the joint are exacerbated, there is scarring of not only affected, but also previously healthy tissues, there are secondary arthrosis.

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