To draw a distinction between slight contracture of the latter and mild paresis of the former is a problem practically always insoluble.
In his opinion, the eye mobility negatived any idea of contracture consequent on central lesions.
No less positive is our refusal to accept as tics spasmodic contractions in association with or subsequent to facial palsy or contracture of peripheral or central origin.
Hence was evolved a unilateral grimace quite unlike any ordinary expression, resembling rather the facies in contracture secondary to facial paralysis.
In a woman suffering from contracture and spasmodic twitchings in the region of the facial, Kennedy, of Glasgow, divided the nerve and immediately anastomosed the cut end laterally with the spinal accessory.
Up to this stage a very feeble degree of contracture of the jaw muscles had been noted, but this speedily became accentuated to such an extent that nasal feeding had to be adopted.
Slight contracture of the fingers is usually the first sign of the malady; in time the muscles undergo further contraction, and this brings about a claw-like deformity of the hand.
From changes in the peri-articular structures there may be contracture in an undesirable position, and in young subjects the growth of the limb may be interfered with.
With the lapse of time they not only become exaggerated, but may become permanent from ankylosis or from contracture of the soft parts round the joint.
Contracture may result from disease of the joint, or from conditions outside it--for example, disease in one of the adjacent bones, or lesions of the nerves.
The secondary changes in joints which are the seat of paralytic contracture are considered with the surgery of the Extremities.
In a case of spastic contracture of the pronator muscles of the forearm, for example, an incision is made along the line of the median nerve above the bend of the elbow.
If the joint is kept rigid for long periods, secondary contracture may occur--in the knee with flexion, in the hip with flexion and adduction.
Recovery is apt to be attended with impairment of movement due to adhesions, ankylosis, or contracture of the peri-articular structures.
As the structures on the flexor aspect are more liable to undergo such shortening, contracture is nearly always associated with flexion.
It is associated with ankylosis of the joint, or contracture of the soft parts or both.
Contracture of Elbow and Wrist following a burn in childhood.
In addition to the different paralytic forms above described, contracturemay result from ulceration and suppuration in the popliteal space, and from disease (osteomyelitis) in one of the adjacent bones.
This is a flexion-contracture which generally involves the second, but sometimes also other toes.
The next symptom to appear is motor paresis, followed by complete paralysis, and later by contracture of the paralysed muscles--spastic paraplegia.
The growth of the limb is impaired, and contracture deformities may supervene (Fig.
Contracture may occur in the muscles affected after the spasms cease.
There is wasting of muscles from disuse, and later a tendency to contracture and the development of deformities, as a result of sclerosis or descending degeneration of the cord.
Six months later the same position was maintained, but the contracturedisappeared under an anæsthetic.
Some contracture of the knee and rigid foot-drop took place, and at the end of twelve months the patient walked poorly with a stick.
It is doubtful whether the skin changes sometimes seen, such as hypothermia, hyperidrosis, cyanosis, and glossiness are due to circulatory disorder induced by the contracture or to the prolonged immobility.
Under kelene-anesthesia the contracture would disappear.
Pressure on the abdomen produced a contracture of the recti.
Achilles reflex on the left side, cyanosis and hypothermia of the left foot, weakness and limitation of movements in the left foot, with slight contracture in flexion of leg upon thigh.
According to Babinski, therefore, Dejerine’s cases, far from proving that hysterical anesthesia could abolish the plantar cutaneous reflexes, proved that hysterical contracture might mask reflex movements.
Paralysis may remain flaccid for paralysis, as a rule contracture a long time, and frequently occurs.
Associated with thiscontracture was a white edema of the hand.
The genesis of the condition appears to be a contracture of the diaphragm in a low position of forced inspiration.
If upon a limb of a lethargic subject who has been rendered cataleptic by opening the eyes, an Esmarch's band be applied, pressure over the bloodless muscles excites no contracture until the band is removed.
The tendinous reflexes are exaggerated; pressure over a muscle, or upon a nerve, arouses a peculiar contracture of synergic muscles and groups of muscles that are supplied by the excited nerve trunk.
A contracture is then developed, and it may be transferred to the opposite limb by the approach of a magnet.
