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Author Topic: Back contractures?  (Read 1379 times)

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alps

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Back contractures?
« on: August 27, 2014, 02:38:09 PM »

I read about someone not able to straighten his back after femur lengthening of 4cm.

Are back contractures common? I ask because no one talks about these.
Would this be a reason to prefer tibial lengthening over femur lengthening?

EDIT: And generally what is the link between femur lengthening and other parts of the body : hips and back.
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TRS

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Re: Back contractures?
« Reply #1 on: August 27, 2014, 03:41:28 PM »

When the quadricep muscles start to become tight and short during the lengthening phase, then this will pull the hips towards the front of the thighs. The back will also follow the hips and cause the "duck ass".
If the hamstrings tighten and shorten then your hips and back will be pulled backwards, towards the back of the thighs.
Both of this conditions become a problem when standing and lying down.

With tibia lengthening, you risk ankle contractures "ballerina foot" and also knee contractures.

All contractures are serious and therefore physiotherapy is extremely important during LL!
« Last Edit: August 27, 2014, 03:52:07 PM by TheRisingShorty »
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alps

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Re: Back contractures?
« Reply #2 on: August 27, 2014, 05:44:52 PM »

Have there been cases of unrecovered contractures (even with rigorous physio)?
Insane (Dr. M) from the old forum seems to have back contractures and apparently had another surgery for it.

Also when people say they have a duck ass is it the same as a back contracture?
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TRS

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Re: Back contractures?
« Reply #3 on: August 27, 2014, 07:10:47 PM »

Have there been cases of unrecovered contractures (even with rigorous physio)?
Insane (Dr. M) from the old forum seems to have back contractures and apparently had another surgery for it.

Also when people say they have a duck ass is it the same as a back contracture?
Usually when a contracture is very severe and cannot be treated with physio or other methods then a release surgery is done. I'm not sure about any unrecovered contractures.
Contractures can happen anywhere in the body when soft tissues shorten therefore different parts of the back can be affected. LL primarily causes knee, ankle, toe, and hip contractures.
Since duck ass involves the quads, I don't think that it is considered a back contracture. But when the hips are moved forward the back will be affected by moving along with the hip. Due to the unnatural position of the back, this may lead to other contractures. But it's good to confirm this with a doctor.

Here is a paragraph from Dr.Paleys site about contractures involved with LL.
Muscle Contractures
Contractures occur when the soft tissues cannot accommodate changes in bone length. To treat contractures effectively, one
needs to identify the potential problem muscles. In tibial lengthening, for example, the problem muscles are the gastrocnemius
and toe flexors. As a result, patients can develop knee flexion, ankle plantar flexion, and toe flexion contractures. In the femur,
both rectus femoris and hamstring muscles resist lengthening. This can result in a fixed flexion deformity of the knee and a
flexion range of motion deficit. Lengthening of the humerus involves the fewest problems. If problems do arise, they are the
result of biceps and brachioradialis tightness. In the forearm, finger flexors tighten more quickly, causing proximal and distal
interphalangeal flexion and hyperextension of the metacarpophalangeal joints.
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