Knee Joint Contracture Research Articles

Postisometric relaxation and reflexotherapy in the treatment of pesttraumatic and immobilized contractures

As many as 115 patients with posttraumatic and immobilized contractures of humeral and knee joints are treated using postisometric relaxation and acupuncture. The best results are obtained in the associated use of the given methods. The mechanisms of the therapeutic action of the given methods are dis cussed.

大腿骨遠位端骨折の治療経験

In most cases, distal epiphyseal fracture of the femur turns out to be an intra-articular fracture. Compounded with the knee joint contracture and other problems. it poses a difficult challenge even to today's advanced bone fracture treatment.Briefly presented herein are therapeutic experiences on 17 such fractures encountered from January 1986 through November 1989.Fifteen patients (nine males, six females: average age, 46.5 years) were studied. Bone fractures were classified in terms of Seinsheimer's classification and results evaluated with Neer's criteria.Types I through III showed good results, even with surgical treatment. However, Type IV c was accompanied by knee joint contracture both at time of injury and after surgical intervention: thus, results were poor and justified secondary surgery.

Use of Serial Casting in the Management of Knee Joint Contractures in an Adolescent with Cerebral Palsy

Treatment of adolescents with cerebral palsy often presents clinical problems that differ from those encountered when treating younger children with cerebral palsy. Muscle contractures, which may not yield to traditional therapeutic exercise, may be a problem. The purpose of this case report is to describe the use of serial casting in the treatment of knee joint flexion contractures in an adolescent with cerebral palsy.

Joint contractures: Huang T. T., Blackwell S. J. and Lewis S. R. (1978) Ten years of experience in managing patients with burn contractures of axilla, elbow, wrist and knee joints. Plast. Reconstr. Surg.61, 70

Joint contractures: Huang T. T., Blackwell S. J. and Lewis S. R. (1978) Ten years of experience in managing patients with burn contractures of axilla, elbow, wrist and knee joints. Plast. Reconstr. Surg.61, 70

Juvenile Hyalin Fibromatosis

A boy had multiple large tumors on the scalp, whitish nodules on the nape and both sides of the neck, hypertrophic gingiva, and severe flexural contractures of hip and knee joints. The histopathologic structure of the tumor was characteristic of juvenile hyalin fibromatosis. The tumor cells were embedded in an amorphous eosinophillic ground substance. X-ray films revealed numerous osteolytic and osteociastic lesions that are important findings in the study of this disease.

Abnormal Glucose Metabolism in Diastrophic Dwarfism

A case study details the clinical, biochemical, and roentgenographic findings in a diastrophic dwarf. The clinical findings were scoliosis and lordosis of the spine, club feet, cleft palate, dysplastic hips, and flexion contractures of knee joints and short extremities. Biochemical abnormalities observed were high cholesterol level, abnormal glucose tolerance, low growth hormone levels, and abnormal excretion of xanthurenic and kynurenic acids following tryptophan loading.

Features of patellar fractures in knee joint contractures

Patellar fractures in patients suffering from knee joint contractures have their own characteristics and are not described in the literature.

Use of Antihemophilic Factor (Plasma Fraction I-0) during Correction of Knee-Joint Deformities in Hemophilia A

Three cases of chronic knee-joint contractures in patients with severe hemophilia A were corrected to near full extension without significant hemorrhage by using a human antihemophilic factor concentrate, fraction I-0, prepared by the glycine method of Blombäck and Blombäck. The amount of substitution needed was adjusted on the basis of serial determinations of the antihemophilic factor concentration in the patient's plasma. The flexion contractures were corrected by skin traction for two to three weeks followed by an extension brace for a few more weeks. In one of these patients, a supracondylar wedge osteotomy was subsequently done to correct a 30-degree valgus deformity of the knee. Prior to intervention, the children were unable to walk. Postoperatively they could walk unaided and even cycle and ski despite persistent limitation or absence of knee flexion. It is emphasized that adequate substitution therapy in hemophilia, based on serial determinations of the plasma antihemophilic factor levels, is now feasible.

Rehabilitation of Fractures in the Aged

In the present paper the aged are defined for convenience sake as those who are over 60 years old. In the authors' hospital 2, 614 in-patients have undergone the orthopedic functional training, and the aged patients among them are 84 in number (3.2%), 61 cases (73%) of which had fractures. Among fractures in the aged those of the femur predominate, and then come the vertebral and the fibula and tibia fractures. The patients at the age of 65 make up the largest number, and the number of male-patients is twice as large as that of female. As the cause of fractures tumbling predominates, then, falling and blow. After they sustained fractures 23% of the patients retired from their jobs, and 7% changed their jobs. In comparison with the younger patients of fracture the aged patients are naturally slower to develop bony union and consequently the period of plaster fixation, hospitalization, and training is likely to be prolonged. Besides, because of the atrophy of soft tissues during this period the adjacent joints tend to develop contractures easily.Since the aged are generally lacking in active motivation for the functional recovery return to the society and very prone to accidents, it is of importance to watch them closely during the orthopedic functional training, and to give them a positive psychological support, while taking the above tendencies into consideration. At the same time it is necessary to direct them with sympathy and kindness to continue the functional training by themselves regularly without undue overstrains. This should also be taken into consideration in cases of the aged patients. Besides, the treatment of the aged patients who suffer from complications requires the utmost caution. However, through above mentioned cautious treatment and training it is possible for the aged patients to recover their function to a level as high as that of the ordinary patients, though it must be admitted that the level of recovery of the aged is slightly lower as expected. But the question remains in the case that the knee joint contracture is apt to stay on even after the treatment of lower limb fracture, as in the cases of general fractures.The questionaire on pain was sent to 37 patients who had undergone the hospital training. Answers were obtained from 77% of them. Generally speaking, among pains numbness predominates, but the incidence of numbness among the aged patients is lower than that among the ordinary patients. And pain occurs most frequently in cold environment and then at the time of fatigue. The cause of pain is the impediment of blood circulation at the affected part. The incidence of pain caused by the impediment of blood circulation is rather high among the aged. And the means of treatment given by the patients are hot spring bath, massage, and hot compress in order. The questionaire indicates that such heat treatments as hot spring bath and others relax muscle tones at the affected part, relieve nervous excitability and improve circulation, and at the sametime, psychologically give them a peaceful rest. The fact acupuncture and moxacautery are resorted to by some patients is considered co be characteristic of the aged.The questionaire on activities of daily living was sent to 23 patients who had undergone the hospital training (16 of them were judged physically handicapped according to the National Annuity Law), and to 6 patients who had received the indoor training. All these patients suffered from fractures of the lower limb and trunk. It is important to notice that the patients of lower limb fracture comlain-ed mainly of difficulty in walking and kneel sitting. By the examination according to the National Annuity Law quite many patients of fractures are judged physically handicapped, because of their inability to do kneel or crosse legged sitting. in sitting upright or cross legged. This kind of impediment becomes serious for the Japanese who spend their home life on tatami matts.