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He had a contracture of his neck towards the left side as well as a dilated left pupil and a loss of motor function of his left leg.
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This advantage may not be clinically evident by tests done for over activity [13] because the hamstrings and gastrocnemius are essentially normal in such cases, neither having a contracture nor fibrosis of their substance.
Open capsulotomy, or scoring of the capsule without removing it, is similarly unsuccessful and has a contracture recurrence rate of over 50% [ 11].
Another patient had a knee contracture after femoral lengthening, tibial lengthening and gradual foot deformity correction through a V-osteotomy that persisted for 1 year; this patient declined further treatment.
Half of their patients had a shoulder contracture of > 10°.
We decided not to calculate the post-treatment group effect on knee and hip extension mobility as none of the patients had a flexor contracture.
Only 9/15 (60%) who were allocated to wear a splint but did not met the criteria for adequate wear had a PIP contracture of 10 – 40 or >40 degrees.
Rives's study highlights the important effect which patient compliance has on the efficacy of splints on final extension deficit, though this is contradicted by Ebscov's results which showed that a greater proportion of patients who had complied with splint wear had a recurrent contracture of 10 40 or >40 degrees.
The results at 9 months showed that a greater proportion of patients 12/15 (80%) in the splint group including those who met criteria for adequate wear (> 3 months) had an increased contracture of the PIPJ of 10 – 40 or > 40 degrees (see table 1a) compared to the no splint group (45%).
Three patients had a 5° flexion contracture, while another three had approximately 10° of contracture.
All the patients had a knee extension contracture averaging 17° (0°–50°) pre-operatively.
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