senile contracture
Introduction
Introduction to old age collapse Contracture refers to the long-term spasticity or a certain position of a muscle or joint, causing muscle atrophy, joint deformation and fixation, which in turn causes dysfunction of the body and local pain. Due to the etiology, collateral is more common in the elderly, and often occurs in the limbs and nearby joints, which is an important reason that affects the rehabilitation of the disease and reduces the quality of life of the elderly. basic knowledge The proportion of illness: 0.005% Susceptible people: the elderly Mode of infection: non-infectious Complications: spinal muscular atrophy
Cause
Cause of senile contracture
Motor neuron disease (30%):
From the cerebral cortex motor area to the cortical brain stem bundle, the corticospinal tract, and then to the motor neurons and extrapyramidal lesions in the anterior horn of the spinal cord, all of which can cause spasm, after treatment, some patients recover, and some collapse. Mainly found in the following diseases:
1 cerebrovascular disease: cerebral hemorrhage, cerebral infarction, subarachnoid hemorrhage, cerebral vascular malformation, etc. Generally speaking, acute cerebrovascular disease can be contracted at 2 weeks.
2 space-occupying lesions: brain tumors, spinal cord, external tumors, disc herniation, hypertrophic spondylitis.
3 inflammation: various encephalitis, myelitis and parasitic encephalopathy.
4 injury: brain contusion, epidural (lower) hematoma, spinal cord injury.
5 demyelinating diseases: multiple sclerosis, optic neuromyelitis and so on.
6 spinal vascular disease: spinal cord ischemia, spinal artery thrombosis, intraspinal hemorrhage.
7 extrapyramidal diseases: Parkinson's disease, torsion and so on.
Paroxysmal tendon (10%):
More common in low-calcium convulsions and spontaneous muscle spasms, the latter occurs in relatively healthy middle-aged and elderly people, manifested as rest (especially during sleep) or mild activity when there is a painful contraction of the calf or foot muscles or toe Strong grievances, unless frequent episodes, paroxysmal tendons do not cause contractures and limb dysfunction.
Rheumatism and rheumatoid arthritis (30%):
Due to the joint movement disorder and the inflammation of the surrounding connective tissue, collagen fibrosis and muscle damage, joint contracture deformation, more common in the knee joint, other joints can also occur.
Fracture (20%):
All fractures can contract, not only the fracture site fixed by cast, but also the normal site is prone to contracture after prolonged bed rest.
Volkman curls (10%):
The contraction of the hand and wrist due to ischemic necrosis of the elbow or forearm flexor tissue is a complication of upper limb trauma. Senile contracture is caused by muscles or muscle groups and joints in a state of paralysis or a specific position, resulting in muscle atrophy, joint deformation and fixation, resulting in dysfunction of the body.
Prevention
Elderly contracture prevention
Active or passive exercise and proper functional exercise as soon as possible, place the joints and limbs in a certain position and change the position in time; apply drugs, physiotherapy or joint function traction to reduce the body pain; these methods are important measures to prevent the occurrence of contractures. In the long run, as long as the indications are properly mastered, early exercise therapy will have no effect on the primary disease.
Complication
Geriatric contracture complications Complications spinal muscular atrophy
It can be complicated by muscle atrophy, joint deformation, fibrosis around the joint ligament, destruction of soft tissue structure, and limited bone bridge activity in joint space.
Symptom
Symptoms of senile contracture Common symptoms Muscle contractures, ischemic contracture, forearm and hand muscles...
Muscle spasm and atrophy
Intermittent or persistent involuntary contraction of muscles or muscles, resulting in the proliferation of connective tissue collagen fibers between muscles; limiting muscle activity, causing muscles to be passively shortened or fixed in axillary shortening; coupled with poor blood circulation and decreased mobility, resulting in Muscle abandonment and dystrophy atrophy, because the extensor muscles of the lower limbs predominate, the limbs are in a stretched state when the lower limbs are contracted; on the contrary, the upper limbs are in a flexed state when they contract.
2. Joint deformation and fixation
Because the patient places the limb in the most comfortable position or can not move autonomously, plus the pulling of the tendon muscle, the ligament fibrosis around the joint, the collagen fibers of the connective tissue proliferate, the soft tissue structure is broken, the bone bridge appears in the joint space, and finally the muscle of the joint is caused. Sexual contracture and deformation, fixation, and reduced joint mobility (ROM).
3. Clumsy slack exercise or less movement
Due to muscle contracture and joint deformation, fixation, decreased limb viability, reduced exercise or only simple movement and awkward spasm, at the same time, due to the disease itself or psychological factors, elderly patients are often reluctant to move their limbs or even refuse Passive exercise delays the healing process.
4. Physical pain
Both the primary disease and contracture can cause limb pain or clonic, increase the patient's pain, and make the patient less willing to move the affected limb and affect the recovery of its function.
Examine
Elderly contracture examination
The blood is normal.
X-ray examination, joint deformation.
Diagnosis
Diagnosis and identification of senile contracture
Diagnostic criteria
According to the history, symptoms, signs, contractures are easy to diagnose, but the occurrence of contractures is affected by the etiology, individual differences, preventive measures, etc., and the degree of contracture is also different. Clinically, according to the degree of tendon, the contracture is divided into three levels:
1 Mild contracture: rapid passive movement of the joint to the joint 1/4 of the normal ROM of the joint to feel pain and resistance.
2 Moderate contracture: There is pain and resistance in the fast passive joint to 1/2 of the normal ROM of the joint.
3 severe contracture: rapid passive active joint to the first quarter of the normal ROM of the joint has pain and resistance.
Differential diagnosis
Muscle atrophy still has neurogenic muscle atrophy and myogenic muscle atrophy; the former is caused by lower motor neuron lesions, which are caused by muscle vascular disease or mechanical damage to muscle fiber inflammation or defect.
According to the etiology and clinical symptoms, the signs can be differentiated from the contracture.
