contracture is a joint abnormally bent by shortened
soft tissues in and around the joint. The shortened tissues pull the bone out
of normal position. A contracture may develop in a joint affected by
juvenile idiopathic arthritis (JIA). Because of the
effectiveness of today's treatments, your child probably will not develop
contractures. But if a contracture does develop, treatment may include
splints and physiotherapy.
Surgery is rarely used to treat
JIA. But it is sometimes used to release contractures of at least moderate
severity that have not responded to other treatments. Surgery is sometimes
needed to restore motion, especially for hip and knee contractures that
interfere with walking.
One procedure used is soft tissue releases
of contractures, which involves cutting the muscles attached to an abnormally
bent joint. As the muscles and other shortened tissues are released, the
affected joint can return to a more normal position.
Goals of soft
tissue releases of contractures include:
Returning the joint to a more functional
Increasing range of motion.
Casts are usually used for several weeks after contracture
releases of the knee, followed by physiotherapy and nighttime splinting.
This procedure often relieves the contracture and pain associated with it and
makes it easier for the child to move the joint.
after a soft tissue release is essential to benefiting from the
procedure. For this reason, children must be at least 6 years old to be
considered for this surgery.
ByHealthwise Staff Primary Medical ReviewerSusan C. Kim, MD - Pediatrics Brian D. O'Brien, MD - Internal Medicine Martin J. Gabica, MD - Family Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerJohn Pope, MD - Pediatrics