前臂缺血性肌挛缩早期手术治疗

目的探讨前臂缺血性肌挛缩早、晚期手术疗效,提出早期行肌肉神经松解减压术的重要性。方法回顾性随访、分析1988年1月~1997年12月收治的42例前臂缺血性肌挛缩早、晚期手术远期效果、观察手内在肌挛缩程度、手部感觉功能恢复与手术距受伤时间之间的关系。结果获随访26例,随访时间半年~10年。早期(6个月内)手术19例,优良率84.2%。晚期(6个月以上)手术7例,优良率28.6%。结论肌肉神经松解减压术宜早期施行。手术时间在损伤后3个月内最佳。晚期手术效果差的主要原因是神经长时间卡压致手内在肌挛缩、感觉丧失。

Early operation of Yolkmann's contracture of the forearm

objective The outcome of early and late operations for volkmann's contracture of the forearm was studied and the impartance of early surgery of decompression of the nerves and release of the muscle was raised. Methods The analysis of the long outcome of early and late operation for volkmann's contracture of the forearm was applied in the former 42 cases (from 1998, I to 1997, 12), the extent of hand muscle contracture was observed and the relationship between the restoration of hand sense function and the intervals from injuries to the operation was explored. Results 26 cases were reviewed. The reviewing time ranged from 1 year to 10 years. Early operation (within 6 months) for 19 cases were reviewed The result of 14 cases was excellent (S3M4), 2 good (83 M3), and 3 fair (S2M2), The percentage of being exceIlent and good was 84 2% . Late operation for 7 cases was reviewed The result of 2 cases was good (S3 M3) , one fair (S2 M2) and 3 bad (S1 M2). The percentage of being excellent and good was 28.6%. The shorter the intervals from injuries to the operation were, the less severe hand muscle contracture was, and the more satisfactory the restoration of hand sense function was. Conclusions The operation of decompression and release of the musele and nerves should be performed earlier The best timing for operation is within 3 months after injuries. In the course of the operation for children, muscle pulling power should be adjusted bigger than relaxation position, The main reason that the outcome of late operation was bad was that long compression of the nerves resulted in hand muscle contracture and loss of sense.