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Spasticity and contractures

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Contractures - fibrotic changes in muscles, joint capsules, and tendons secondary to a joint remaining in a fixed position - may be prevented by daily moving paralysed limbs through a complete range of movement at each joint.

Spinal reflexes gradually return in the early weeks after the stages of spinal shock. Flexor spasms or withdrawal reflexes result from slight stimuli to the lower limbs and must be discouraged since they cause the patient to spend more time with the hips and knees flexed in spasm. Daily passive movements may be effective at preventing this, but usually, antispastic drugs such as baclofen are required. Drowsiness prevents the use of high doses of diazepam and dantrolene may cause hepatotoxicity.

Rarely, surgery is indicated to relieve contractures.

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