Contractures. A major complication of craniocerebral trauma.

Contractures in craniocerebral trauma patients are a common problem noted during inpatient rehabilitation. Many factors influence this complication. Seventy-five consecutive cases of craniocerebral trauma observed during a one-year period were evaluated as to the duration of coma, degree of paralysis, treatment facility, and presence of fractures including their relation to contractures. Contractures measured by standard goniometric techniques were defined as loss of range of motion in a joint to a degree that impedes activities of daily living. The incidence of contractures was 84%. The most commonly affected joints were the hips (81%), shoulders (76%), ankles (76%), and elbows (44%). There was a statistically significant increase in the presence of contractures with prolonged duration of coma. Patients with contractures that developed independently of the facility where treated were examined for the presence of fractures. The emphasis after acute craniocerebral trauma is on life preservation. Limb positioning and maintenance of joint motion, which are imperative for the functional activity, have not received the attention necessary for the long-range welfare of the patient.