Clinical features associated with forms of torture - Ligaments

Exceeding the normal range of movement in a joint or loading the joint by traction, as in suspension and other types of positional torture, the ligaments may be sprained. An inflammatory response with swelling, pain and joint dysfunction will be present in the acute phase. In a first-degree distortion, the ligaments are sprained without macroscopic rup- ture, and there will be no mechanical instability in the joint. In a second-degree distortion, there will be a partial macroscopic rupture of the ligaments, leading to a slight mechanical instability in the joint. In a third-degree distortion, the liga- ments will be completely ruptured and the joint clearly mechanically unstable. The healing process in ligaments and tendons is considerably slower than that of muscles. A full recovery with normalization of strength and function takes months. Pain and joint dysfunction are very frequent complaints in the chronic phase. At clinical examination, reduced range of movement in peripheral joints, as well as in the spine, is the most typical finding, but various degrees of joint laxity/instability may also be found . Specific clinical tests may be applied for diagnosing the instability and direction of instability in joints.