After working on many cases involving the development of pressure sores in a nursing home or other long term care settings, I am convinced that contractures are a tremendously under-appreciated threat to patient health. Like many ailments, we are now learning that getting older should not necessarily mean developing disabling conditions such as contractures- with the proper nursing care.
What are contractures?
Contractures are a medical condition where a joint is held in a fixed position (frozen joints) due to the shortening of a muscle or tendon due to stress exerted on the muscle or spasticity (uncontrolled muscle movement). Older patients and those with limited mobility are especially prone to develop contractures. Contractures most commonly form in the: hands, feet, arms and legs.
How can contractures be treated?
Once an individual has developed contractures, little can be done to alleviate the problem aside from aggressive orthopedic surgery. Consequently, medical facilities (hospitals and nursing homes) should provide physical and occupational therapy to people who are at risk for developing contractures and to keep the body flexible.
Complications associated with contractures
Once a person has developed contractures they are at a heightened risk for developing bed sores (similarly referred to as decubitus ulcers, pressure ulcers or pressure sores) due to their bodies limited ability to move– with or without assistance. The rigidity that accompanies contractures generally means that many of the repositioning techniques commonly used to prevent bed sores may be difficult to implement. As a general rule, the more immobile an individual is, the higher likelihood they have in developing bed sores.
Patients with contractures are also at risk for falls and being mishandled by staff as the rigid limbs can make daily rituals such as bathing, transferring to and from bed or wheelchair more difficult. Consequently, facilities should use additional care, such as extra staff or lifting devices, when handling patients with contractures.