MyMedR

Loh KY, Kew ST

Aust Fam Physician, 2008 Mar;37(3):150.

An Indian man from Malaysia presented with contracture of his hands. He is 55 years of age and has a history of chronic alcohol consumption. Examination revealed bilateral thickened structure at the palms.

Matched MeSH terms: Dupuytren Contracture/diagnosis*; Dupuytren Contracture/therapy

Use of a New External Fixator for the Correction of Fixed Flexion Deformity of the Fingers

Siow YS, Ahmad TS, Goh SY

Hand Surg, 1999 Dec;4(2):167-174.

PMID: 11089175

Three patients with severe fixed flexion deformity of the fingers caused by trauma were reported. As an alternative treatment, a new mini external fixator was used to correct the deformities. The use of this device has made treatment of contractures simpler and more predictable. Gradual distraction and straightening was applied to loosen and extend the joints, followed by a period of mobilisation while still on the device. In all the three patients, this experimental device and approach led to improvement of the fixed flexion deformities. With use of this device, surgical release may not be necessary.

Matched MeSH terms: Contracture

Epithelioid sarcoma and concurrent Volkman ischaemic contracture: a case report

Suria-Hayati MP, Siti-Aishah MA, Eshagroni A, Jamari S, Abdolvahab F, Yazmin Y, et al.

Clin Ter, 2012;163(3):215-7.

PMID: 22964694

Epithelioid sarcoma is a very infrequent soft tissue sarcoma involving predominantly distal extremities of adolescent and young adult. We hereby report a case of epithelioid sarcoma in a 34-year-old young adult who presented with 1-year history of a painful left upper limb associated subsequently with warm left forearm swelling and a Volkman contracture. He was treated as an inflamed soft tissue condition of the left upper limb. A computed tomography study showed presence of multiple hypodense lesions mainly in the flexor compartment of the left arm as well at the subcutaneous tissue, which measured 1 to 1.7 cm in diameter. Histological examination of the left upper limb mass showed nodular proliferation of epithelioid tumour cells and some with rhabdoid features surrounding a central zone of necrosis and was diagnosed as epithelioid sarcoma. Concurrent presence of epithelioid sarcoma and Volkman ischaemic contracture are rarely seen in clinical practice. The present case highlights the importance of the histology which can be confused with other types of sarcoma or chronic granuloma and even missed at times thereby causing diagnostic problems.

Matched MeSH terms: Ischemic Contracture/complications*

Comparison between Collagenase Injection and Partial Fasciectomy in the Treatment of Dupuytren's Contracture

Tay TK, Tien H, Lim EY

Hand Surg, 2015 Oct;20(3):386-90.

PMID: 26387998 DOI: 10.1142/S0218810415500288

A comparative study between two treatment methods (collagenase injection and open partial fasciectomy) for Dupuytren's contracture. This study will determine differences in clinical outcome, complication rate and patient satisfaction.

Matched MeSH terms: Dupuytren Contracture

H syndrome - the first report in Malaysia

Low DE, Tang MM, Surana U, Lee JY, Pramano ZAD, Leong KF

Int J Dermatol, 2019 Oct;58(10):e190-e193.

PMID: 31192449 DOI: 10.1111/ijd.14518

Matched MeSH terms: Contracture/diagnosis*; Contracture/genetics; Contracture/pathology

Fulltext Dupuytren's Contracture with Secondary Ulnar Neuropathy

Ng CF

J Neurosci Rural Pract, 2020 Jul;11(3):481-483.

PMID: 32753817 DOI: 10.1055/s-0040-1708459

Dupuytren's disease is a progressive fibrotic condition of the hand. The underlying pathomechanism is not fully known. Dupuytren's contracture can be seen in patients with diabetes mellitus, chronic alcoholism, smoking, or hand trauma. It is uncommon to affect the neurovascular supply causing clinical symptoms. We describe a patient with idiopathic Dupuytren's disease complicated with bilateral ulnar neuropathies and highlight the importance of such rare treatable complication.

Matched MeSH terms: Dupuytren Contracture

Submuscular Plate Stabilisation After Lengthening: Standard and Modified Techniques

Munajat I, Sulaiman AR, Mohd EF, Zawawi M

Malays Orthop J, 2020 Mar;14(1):49-54.

PMID: 32296482 DOI: 10.5704/MOJ.2003.008

Introduction: Submuscular plating after lengthening shortened the period of external fixation in distraction osteogenesis of the femur. In the femur, where monolateral or ring fixators had been used for the distraction, plates, could be inserted laterally, anteriorly or medially. Specific technical modification of the plate insertion, however, would be necessary to accommodate the femoral varus angular correction created at the end of the distraction, in the pelvic support osteotomy lengthening.

Material and Methods: We reviewed a series of eight cases with standard and modified techniques of plating after lengthening. The amount of lengthening, the period of distraction, the external fixator index and the associated complications were assessed.

Results: The mean lengthening was 5cm, with a range of 3cm to 9cm. The external fixation index, the period of external fixators in days in relation to the length of distraction in cm, was between 18 days/cm to 58 days/cm. One patient with quadriceps contracture, underwent quadriceplasty to improve knee flexion. Three patients with transient knee stiffness had resolution with aggressive physiotherapy. One patient with transient hypoesthesia recovered spontaneously. None of the patients developed joint subluxation, deep infection, re-fracture or implant failures.

Conclusion: Standard and modified techniques of plating after lengthening were safe and required only a short period of external fixation. The modified technique offered an easier way of plate insertion in a deformed bone.

Matched MeSH terms: Contracture

Securing the airway in a child with extensive post-burn contracture of the neck: a novel strategy

Wong TE, Lim LH, Tan WJ, Khoo TH

Burns, 2010 Aug;36(5):e78-81.

PMID: 20036061 DOI: 10.1016/j.burns.2009.10.016

Matched MeSH terms: Contracture/pathology; Contracture/surgery*

Fulltext The worldwide prevalence of the Dupuytren disease: a comprehensive systematic review and meta-analysis

Salari N, Heydari M, Hassanabadi M, Kazeminia M, Farshchian N, Niaparast M, et al.

J Orthop Surg Res, 2020 Oct 28;15(1):495.

PMID: 33115483 DOI: 10.1186/s13018-020-01999-7

BACKGROUND: The Dupuytren disease is a benign fibroproliferative disorder that leads to the formation of the collagen knots and fibres in the palmar fascia. The previous studies reveal different levels of Dupuytren's prevalence worldwide; hence, this study uses meta-analysis to approximate the prevalence of Dupuytren globally.

METHODS: In this study, systematic review and meta-analysis have been conducted on the previous studies focused on the prevalence of the Dupuytren disease. The search keywords were Prevalence, Prevalent, Epidemiology, Dupuytren Contracture, Dupuytren and Incidence. Subsequently, SID, MagIran, ScienceDirect, Embase, Scopus, PubMed and Web of Science databases and Google Scholar search engine were searched without a lower time limit and until June 2020. In order to analyse reliable studies, the stochastic effects model was used and the I2 index was applied to test the heterogeneity of the selected studies. Data analysis was performed within the Comprehensive Meta-Analysis Software version 2.0.

RESULTS: By evaluating 85 studies (10 in Asia, 56 in Europe, 2 in Africa and 17 studies in America) with a total sample size of 6628506 individuals, the prevalence of Dupuytren disease in the world is found as 8.2% (95% CI 5.7-11.7%). The highest prevalence rate is reported in Africa with 17.2% (95% CI 13-22.3%). According to the subgroup analysis, in terms of underlying diseases, the highest prevalence was obtained in patients with type 1 diabetes with 34.1% (95% CI 25-44.6%). The results of meta-regression revealed a decreasing trend in the prevalence of Dupuytren disease by increasing the sample size and the research year (P < 0.05).

CONCLUSION: The results of this study show that the prevalence of Dupuytren disease is particularly higher in alcoholic patients with diabetes. Therefore, the officials of the World Health Organization should design measures for the prevention and treatment of this disease.

Matched MeSH terms: Dupuytren Contracture/etiology; Dupuytren Contracture/epidemiology*

Fulltext Treatment for flexion contracture of the knee during Ilizarov reconstruction of tibia with passive knee extension splint

Kwan MK, Penafort R, Saw A

Med J Malaysia, 2004 Dec;59 Suppl F:39-41.

PMID: 15941159

Joint stiffness is one of the complications of limb procedure. It developes as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the affected joint. We are reporting four patients who developed fixed flexion contracture of their knees during bone lengthening procedure for the tibia with Ilizarov external fixator. Three of them were treated for congenital pseudoarthrosis and one was for fibular hemimelia. None of them were able to visit the physiotherapist even on a weekly basis. A splint was constructed from components of Ilizarov external fixator and applied on to the existing frame to passively extend the affected knee. Patients and their family members were taught to perform this exercise regularly and eventually near complete correction were achieved. With this result, we would like to recommend the use of this "Passive Knee Extension Splint" to avoid knee flexion Contracture during limb lengthening procedures with Ilizarov external fixators.

Matched MeSH terms: Contracture/etiology; Contracture/physiopathology; Contracture/therapy*

Fulltext Lower eyelid fornix deepening: A new indication for the facial artery myomucosal flap

Saad AZM, Nordin NR, Sulaiman WAW, Jamayet N, Johar SFNM, Hussein A

Arch Plast Surg, 2021 Jan;48(1):80-83.

PMID: 33503749 DOI: 10.5999/aps.2020.00206

Eye socket contracture is a well-known late complication of enucleation surgery, and the additional insult of radiotherapy at an early age causes even further fibrosis and scarring of the socket. Management of the contracted socket is challenging, and several methods have been proposed. We report a case of eye socket contracture after enucleation and radiotherapy in which multiple reconstructive procedures failed. The recurrent contracture caused difficulty in housing and retaining the eye prosthesis. We reconstructed the lower eyelid with a facial artery myomucosal flap and nasolabial flap, and the upper eyelid with a Fricke flap following reconstruction of the orbital rims (supraorbital and infraorbital rims with a calvarial bone graft, and further augmentation of the infraorbital rim with a rib bone graft). Cosmesis post-reconstruction was acceptable and the prosthesis was retained very well.

Matched MeSH terms: Contracture

Fulltext Modified vacuum-assisted closure

Sia, S.F., Fong, E.P.

JUMMEC, 2006;9(2):24-27.

MyJurnal

The treatment of large ulcers is a problem. Closure with flaps and even skin grafts in compromised patients is often fraught with risks. Dressing these large wounds is also a problem, as they are often heavily exudative. We report our experience using the vacuum-assisted closure technique in managing difficult ulcers in four patients. A modification of the technique using cheap, easily available materials is described. The vacuum-assisted suction is an effective treatment for large ulcers in compromised patients. It facilitates considerable contraction of the wound, and in smaller wounds; the vacuum-assisted closure allows sufficient contracture to enable delayed primary closure. We recommend the use of this method of wound dressing and closure in large wounds particularly, in high-risk patients where extensive flap coverage or even split skin graft would incur considerable risk.

Matched MeSH terms: Contracture

An ulcerated giant segmental hemangioma resulting in contracture of the left elbow

Leung AKC, Leong KF, Lam JM

Paediatr Child Health, 2020 04 24;26(2):e70-e72.

PMID: 33747313 DOI: 10.1093/pch/pxaa050

The majority of infantile hemangiomas are benign and will resolve on their own. We report a 4-month-old infant with an ulcerated giant segmental infantile hemangioma involving the left upper limb who developed a contracture of the left elbow despite treatment with oral propranolol, proper wound care, and regular intense physiotherapy. To our knowledge, contracture resulting from an infantile hemangioma has not been reported previously.

Matched MeSH terms: Contracture

Fulltext The results of treatment of dislocation and fracture--dislocation of the elbow--a review of 41 patients

Azmi I, Razak M, Hyzan Y

Med J Malaysia, 1998 Sep;53 Suppl A:59-70.

PMID: 10968184

Forty-one patients with 42 elbow dislocations, of which 13 had acute simple dislocations, 21 had fracture-dislocations and 8 had neglected elbow dislocations, were evaluated with regard to limitation of motion, pain, instability and residual neurovascular deficit. All patients with acute simple dislocation were treated with closed reduction, but the duration of immobilization before commencement of active motion varied. Open-reduction was indicated for failed closed reduction and neglected-dislocations. Internal fixation as a primary procedure was only performed for displaced fracture-dislocation. Excision of radial head or tricepsplasty were performed if the reduction was impossible in neglected elbow dislocation. Despite a good results in acute simple dislocation, 33.07% had flexion contracture of between 5 to 30 degrees. In fracture dislocation, satisfactory results were seen in whom the elbow was immobilized for three weeks or less. Neglected-dislocation is associated with poor functional outcome, 37.5% were good and 62.5% were poor. Prolonged immobilization after injury was strongly associated with an unsatisfactory result. The results indicate that early properly supervised active motion is a key factor in the rehabilitation of elbow dislocation.

Matched MeSH terms: Contracture/etiology

Awareness, potential factors, and post-amputation care of stump flexion contractures among transtibial amputees

Ghazali MF, Abd Razak NA, Abu Osman NA, Gholizadeh H

Turk J Phys Med Rehabil, 2018 Sep;64(3):268-276.

PMID: 31453521 DOI: 10.5606/tftrd.2018.1668

Objectives: This study aims to assess the level of awareness of transtibial amputee patients on stump contractures and their compliance with efforts implemented to prevent the condition.

Patients and methods: This study included 50 unilateral transtibial amputees (26 males, 24 females; mean age 55.4±14.7 years; range, 18 to 78 years) who met the respondent criteria of the study. The respondents were randomly selected and were issued with a questionnaire.

Results: The majority of the transtibial amputees were aware of stump contracture complications. It was found that they also preferred methods of prevention which required less effort, was cost-effective, and were also practical.

Conclusion: More focus should be placed on contracture prevention methods which were most complied with by the patients. This is because the effectiveness of a prevention method is highly influenced by patients' compliance with the method. Patients with a higher risk of developing stump contractures should be also given more attention in post-amputation care.

Matched MeSH terms: Contracture

Fulltext Dupuytren Contracture in a Patient with Congenital Camptodactyly and Incidental Carpal Tunnel Syndrome

Mahendran, S, Paisal, H., Ng, E.S., Sara, T.

Malays Orthop J, 2008;2(2):37-39.

MyJurnal

Dupuytren contracture is commonly seen in northern European populations but not in Asians. Even more rare is a presentation of flexion deformity of fingers involving two different pathologies with incidental carpal tunnel syndrome in the same patient. We report herein a case of Dupuytren contracture with congenital camptodactyly and unilateral carpal tunnel syndrome.

Matched MeSH terms: Dupuytren Contracture

A 6-year safety surveillance of 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in South Korea

Lee SM, Lee JH, Song ES, Kim SJ, Kim JH, Jakes RW, et al.

Hum Vaccin Immunother, 2018 Aug 07.

PMID: 30084702 DOI: 10.1080/21645515.2018.1502525

In 2010, Korea introduced 10-valent pneumococcal conjugate vaccine for children aged 6 weeks to 5 years against invasive disease caused by Streptococcus pneumoniae serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, 23F and cross-reactive 19A. The aim of this 6-year real-world study of 646 healthy Korean children from 16 centers vaccinated in routine practice is to monitor vaccine safety, as per Ministry of Food and Drug Safety regulations. Around 50% had a past or existing medical condition, 19.3% an existing condition and 7.6% received concomitant medication). Total of 489 recorded adverse events (AEs) were reported in 274 infants; 86% were mild and the rest moderate, only three were reported as serious. Most AEs (97.8%) were not related to vaccination; one case of injection-site swelling and of fever was related, two cases of fever were probably related, five cases of fever and one case each of diarrhea and coughing were possibly related. None of the serious AEs were related to vaccination. Of 11 adverse drug reactions (ADRs) in 10 subjects, none were serious. Overall, 263 subjects (40.7%) received medication (mainly antibiotics or antipyretics) for the treatment of an AE, of which 6 subjects were treated for an ADR. There was no difference in the incidence of AEs according to age, sex or concomitant vaccination. Subjects with an existing medical condition had significantly more AEs than those without any conditions (p = 0.03), but no differences regarding ADRs. Four-dose vaccination with PHiD-CV appears to have a clinically-acceptable safety profile for Korean children. ClinicalTrials.gov identifier: NCT01248988.

Matched MeSH terms: Contracture

Fulltext Posterior Elbow Dislocation with Brachial Artery Thrombosis Treated Non-surgically: A Case Report

Lim SM, Chua GG, Asrul F, Yazid M

Malays Orthop J, 2017 Nov;11(3):63-65.

PMID: 29326772 MyJurnal DOI: 10.5704/MOJ.1711.008

The brachial artery is rarely injured in closed posterior dislocation of the elbow, unlike the high rate of vascular injury seen after dislocation of the knee. Despite the anatomical proximity of the brachial artery to the elbow joint, most cases of brachial artery injury after dislocation of the elbow are related to an associated fracture, an open injury or high-energy trauma. A high index of suspicion should be maintained as well as a thorough neurovascular examination with regards this potentially disastrous complication. We describe an unusual case of complete thrombosis of the brachial artery presenting with a posterior elbow dislocation following a fall (low energy trauma) that was treated nonoperatively. At three months follow-up, patient had good circulation over the affected limb, no complaints of ischemic pain or cold intolerance, no signs of Volkmann's ischemic contracture, and a range of motion that was comparable to the contralateral limb.

Matched MeSH terms: Ischemic Contracture

Maid abuse

Murty OP

J Forensic Leg Med, 2009 Jul;16(5):290-6.

PMID: 19481715 DOI: 10.1016/j.jflm.2008.12.020

Domestic maid violence is an assault and coercive behaviour, which mainly includes physical, psychological and at times sexual too, by employer or household members of employer against a person hired as a domestic help. Maid abuse is well known but poorly documented in scientific literature. This is an important global issue. In this article, two illustrated cases of maid abuse are discussed. Their employers allegedly subjected both the victims to physical and psychological trauma. The physical examination of the victims showed poor state of clothing, nutrition, and presence of injuries of different duration. The bruises were irregular to patterned, and were inflicted by beating. Both cases had eczematous contact dermatitis over palms and soles, paronechia, and sub-ungal fungal infection due to unprotected working in wet conditions. In both cases, external ears were deformed like cauliflowers due to repeated trauma. All cases had multiple injuries of varying duration. In this paper, medico-legal and social issues related to maid abuse are also discussed in detail. A possible solution to minimise maid abuse is also suggested. This paper highlights and document maid abuse.

Matched MeSH terms: Contracture/etiology

Musculoskeletal lesions in yaws

Sengupta S

Clin Orthop Relat Res, 1985 Jan-Feb;?(192):193-8.

PMID: 3967422

Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.

Matched MeSH terms: Contracture/etiology

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