Hesperian Health Guides
Chapter 59: Correcting Joint Contractures
Information on contractures, their causes and prevention is in Chapter 8. Exercises to prevent and correct contractures are in Chapter 42.
Joint contractures can often be gradually straightened with casts or braces that gently but firmly hold the joint in a stretched position for a long time. We stress gently because unless great care is taken it is very easy to cause injuries.
| To straighten a limb, 3 areas of pressure are needed. | In theory, the leg could be straightened like this. | In fact, this would cause pressure sores on the small areas where the splint presses. | ||
| 1. | 1. | |||
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| 2. | 3. | 2. | 3. | Also, the knee could be dislocated it the calf is not supported while stretching. |
| WRONG | ||||
Always use wide areas of pressure. Avoid pressure on the knee, behind the heel, and over bony areas.
| BETTER |  | |
| well-padded pieces of cardboard tubes, plastic, plaster, or bamboo | tight strap or band of car inner tube | |
| If a child stays in bed, a stretching aid like one of these might work. (But try to keep the hip straight, so that the aid does not cause a hip contracture while it straightens the knee.) | 
BETTER
weight here |
There are several ways to straighten contractures that let the child continue to move about. These include:
| 1. a series of plaster casts | 2. adjustable braces | |
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| 3. elastic stretching aids of bamboo or inner tube | 4. adhesive strapping | |
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Read about the advantages and disadvantages of the first 3 ways before deciding which one to use for a particular child. The 4th method (strapping) is used mostly on clubbed feet of newborn babies.