Contractures complicating spinal cord injury: incidence and comparison between spinal cord centre and general hospital acute care.

One hundred and eighty-one spinal cord injured patients admitted to the Rehabilitation Institute of Chicago after acute care following a spinal cord injury were studied. The presence or absence of contractures as well as significant abnormalities with loss of range of motion greater than 15% was recorded. Patients were either admitted from general hospitals or the acute care unit of our spinal centre, Northwestern Memorial Hospital. Patients treated in the general hospitals had a statistically significant increased incidence of contractures compared to spinal centre patients. Patients treated in the spinal centre were transferred to the rehabilitation hospital sooner post injury. An increased time from onset to rehabilitation admission correlated with a statistically significant increased incidence of contractures. Tetraplegic patients had a statistically significant increase over paraplegic patients and were more likely to have contractures of several upper extremity joints. Contracture development was not related to fractures of the extremities. This evidence further supports the need for spinal cord centres and provides data on the incidence of contractures in spinal cord injured patients which has not been reported previously.