Contractura

Contractura, or contracture, is a medical condition characterized by the permanent shortening or stiffening of muscles, tendons, ligaments, or other soft tissues around a joint. This leads to restricted range of motion and often deformity. Contractures arise from fibrosis and excessive scar tissue formation after injury, chronic inflammation, disuse or immobilization, and, in some cases, neuromuscular disorders that alter muscle tone.

Causes include burns and burn scars forming burn contractures, prolonged immobilization after fracture or surgery, inflammatory or degenerative joint diseases, neurological injuries such as stroke or cerebral palsy, and genetic or metabolic conditions. A well-known example is Dupuytren's contracture, in which fibrous nodules in the palm progressively limit finger extension.

Clinical features vary but typically include a reduced passive and active range of motion, and in some cases palpable tight bands or nodules. Pain may be present if the tissue is irritated or if a contracture creates joint misalignment. Diagnosis is usually clinical, supported by imaging tests only when another pathology is suspected.

Treatment aims to restore function and may involve physical therapy with stretching, splinting or serial casting, and sometimes botulinum toxin injections to reduce muscle overactivity. When conservative methods fail or the tissue is severely contracted, surgical options such as fasciectomy, tendon lengthening, or capsular release may be needed, followed by rehabilitation to prevent recurrence.

Prevention focuses on early mobilization after injury or surgery, proper wound care and scar management after burns, and ongoing physical therapy in neuromuscular conditions. The prognosis depends on the cause, degree of contraction, and response to treatment; some contractures respond well to nonoperative care, while others require surgical management.