Kontraktúra

Kontraktúra, or contracture, is a medical condition defined by the permanent shortening or tightening of muscles, tendons, fascia, skin, or other connective tissues, which leads to restricted movement and deformity of a joint. The shortening is typically non-reversible without intervention. The term is used across several medical disciplines and languages, including the form kontraktúra found in some Central European languages.

There are several forms of kontraktúra, classified by the tissue involved. Muscular contracture involves shortening of muscle fibers; tendon or fascial contracture affects the supporting structures around a joint; and skin or scar contracture results from scar tissue, often after burns or injuries. Joint contracture refers to reduced mobility caused by changes in the joint capsule, ligaments, or surrounding soft tissue.

Causes are varied. Prolonged immobilization after injury or surgery can promote tissue shortening. Severe burns, inflammatory or fibrotic diseases, malnutrition, and aging contribute as well. Neurogenic conditions such as cerebral palsy or stroke can lead to abnormal muscle tone and secondary contractures. Repeated microtrauma or poor wound healing may also play a role.

Clinical features typically include a visibly restricted range of motion, a fixed angle of deformity, and often pain or discomfort with movement. Diagnosis is mainly clinical, supported by imaging or electrodiagnostic studies when an underlying neurological or structural issue needs clarification.

Treatment aims to restore function and may involve physical therapy, stretching, splinting, or serial casting. Pharmacologic options like botulinum toxin can be used in select neuromuscular conditions. When conservative methods fail, surgical release or lengthening of affected tissues may be necessary, followed by rehabilitative therapy. Prevention focuses on early mobilization, proper wound care, and scar management.

See also: contracture, burn scar contracture, joint contracture.