Contracture

Definition

A contracture is a permanent fixation of a joint in a non-functional position due to shortening of muscles, tendons, ligaments, or soft tissues. Contractures cause loss of motion and functional disability.

Causes

• Immobility and prolonged bed rest
• Neurologic disorders (stroke, spinal cord injury, cerebral palsy)
• Burns (especially over joints)
• Muscular dystrophy
• Dupuytren's contracture (palmar fascia)

Prevention

Active and passive range-of-motion (ROM) exercises at least twice daily, proper positioning with splints, turning every 2 hours, early mobilization, and functional positioning (avoid foot drop with foot boards, prevent wrist flexion contracture with hand rolls).

Treatment

Aggressive physical and occupational therapy, stretching, splinting, serial casting, intra-articular injections, and surgical release for established severe contractures.

NCLEX Relevance

Prevention is the high-yield focus. Turn and position every 2 hours; perform ROM exercises.