The term contracture may be used in various contexts:
- Clinically, to describe an acquired restriction of joint mobility (prenatally acquired restriction of joint mobility is called arthrogryposis). This may be due to a variety of factors, including prolonged muscle spasticity with or without muscle fibrosis (i.e., without pathological muscle shortening), and ligamentous restrictions. This often occurs in the context of limb immobilization or inactivity, for example in a flexed posture. Injections of botulinum toxin to abolish muscle spasticity may be required to assess whether there is concurrent ligamentous restriction, and thus to plan optimum treatment, which may involve surgery. Contractures of muscular origin may be seen in conditions, such as Emery-Dreifuss disease (especially elbow, Achilles tendon, posterior part of neck) and Duchenne muscular dystrophy.
- Clinically, to describe a hard, contracted muscle, painful to straighten, and lasting several hours following exercise in a metabolic myopathy, such as McArdle’s disease (myophosphorylase deficiency, glycogen storage disease type V); this may be associated with EMG silence.
- Physiologically, to describe a prolonged painful muscle spasm with EMG silence, as observed in myotonia and paramyotonia.