Journal List > J Korean Orthop Assoc > v.28(3) > 1113790

Kim, Kim, Park, and Han: Flexor Sliding Operation for Established Volkmann's Ischemic Contracture

Abstract

Volkmann's ischemic contracture(V,I.C.), despite relatively small incidence, is one of the most devastating complication following a limb injury. The orthopedic surgeon must be equipped to recongnize and effectively treat this complication. Recently, the authors have managed 10 cases of V.I.C. with flexor sliding operation and the following results were obtained. 1. The etiology showed fracture, crushing injury(especially wringer injury) around the elbow, CO poisoning and intravenous injection of drug(CaCl2) on forearm. 2. V.I.C. was classified into three types on the basis of clinical findings relating to the severity of the process by Tsuge. 3. The method of surgical treatment depended upon deformities and functional loss of forearm and hand. Muscular origins of the medial epicondyle and fibrotic muscle were detached subperiosteally in all cases. 4. In cases of sensory impairment, neurolysis or transposition of ulnar nerve was performed. 5. Postoperatively, long arm cast was applied with elbow 90 flexion, the fingers in full extension and the forearm in mild supination. 6. The result of treatment was affected by severity of previous deformities and functional loss. 7. Early postoperative active exercise of the fingers seemed to be helpful in restoring further improvement of finger motion. 8. In all patients, weakness of flexor power developed posoperatively, but improvement of grip power was achieved by long term physiotherapy.

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