Jose Thomas wrote:
>
> Dear List members,
> I would like to get your input regarding a patient who has severe knee
> flexion contracture bilaterally as a result of a immobilisation in POP
> after a bilateral tibia #.The patient is scared of doing a
> surgery(Hamstring release).He wants me to treat him conservatively.I
> have tried out knee mobilisations and some cryotherapy as he was
> complaning of severe pain.The patient was told to lie prone as there was
> a associated contracture of the hip flexors.
Considering the fractures I would check the functions of the proximal
and distal tibio-fibular joints. I would also suggest that the reason to
the flexion contractures of both the knees and the hips might be due to
impaired neurodynamics of the sciatic nerve. If so some gentle
mobilisation of the nervous system may be of help.
Kind regards,
David
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