Contractures
Limbs That No Longer Straighten
8CHAPTER
77
WHAT ARE CONTRACTURES?
When an arm or leg is in a bent position for a long time, some of the muscles become
shorter, so that the limb cannot fully straighten. Or shortened muscles may hold a
joint straight, so it cannot bend. We say the joint has a ‘contracture’. Contractures can
develop in any joint of the body. For example:
1. Miguel spent the first years of
his life crawling because one
leg was paralyzed.
Because he could not
stand, he kept his hip
and knee bent and
his foot in a tiptoe
position, like this.
2. In time, he could
not straighten his
hip or knee, or
bend his foot up.
He had developed a:
You can feel the
hip tight cord here,
contracture
knee
contracture
when you
push here.
‘tip toe’
contracture
of the ankle
3. Because of the contractures,
Miguel could not stand or
walk, even with a brace.
shortened muscles
causing hip contracture
Shortened calf muscles
cause a tight heel cord
that keeps the foot in a
‘tiptoe’ position.
Shortened muscles-that-bend-the-knee
cause tight cords behind the knee.
This keeps it bent.
Contractures develop whenever a limb or joint is not moved regularly through its full
range of motion. This is likely when:
• a very weak or sick child
is in bed for a long time.
• a child with
an amputation
keeps joints
bent.
hip
contracture
knee
contracture
ankle
contracture
• a paralyzed
limb is
kept bent
or hanging.
hip
contracture
knee
contracture
ankle
contracture
• a child has
joint pain
that prevents
her from
straightening
her joints.
contractures in:
——neck
——shoulders
——back
——elbow
——wrists
——fingers
——hips
——knees
——ankles
——feet
——toes