PubMed · 8431267
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A Somhegyi, I Ratko. 1993. Hamstring tightness and Scheuermann's disease. Commentary.. https://doi.org/10.1097/00002060-199302000-00010
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Current knowledge on the epidemiology of major joint contractures is limited. We systematically reviewed the literature to identify studies examining the epidemiology of joint contracture regardless of clinical condition. Epidemiologic measures of interest were prevalence, incidence, and prognostic risk factors. We used Medline to identify all epidemiologic studies of major joint contractures published from 1966 to March 2005. There was a high prevalence of major joint contractures. Most studies focused on one joint rather than including all relevant major contractures. However, most studies did provide a definition of a contracture or the measures used to assess contractures. Immobility is a highly prevalent disability in at-risk populations, and constitutes a tremendous burden to patients in nursing homes, hospitals, and the outpatient community. The lack of epidemiologic data is a major impediment to providing appropriate treatment.
This review is based on the author's experience treating over 5,000 joint contractures of the lower limbs in developing countries in the tropics and subtropics over the past 40 years. It includes realistic methods of correction of neglected, untreated joint contractures mainly due to poliomyelitis and other paralytic conditions by general duty medical officers. Corrections were performed in centers where medical facilities were often limited and where millions of untreated patients still await treatment. The treatment includes percutaneous correction of flexed hips, knees and equinus ankles and rotational osteotomy of the distal femur for severe knee contractures. Surgery is followed by simple cheap braces made out of local materials. These methods will usually allow early mobility, and in severe cases survival instead of early death.
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