Fishchenko P Ia, Tsyretorov S Ts
Ortop Travmatol Protez. 1990 Nov(11):49-53.
In the article is presented the study of clinical aspects and roentgenograms of 91 children with Volkmann's contraction. The causes of contraction with 46 patients were supracondylar fractures of arm and with 32--forearm bone fractures. All fractures were associated with massive injures of soft tissues, some of the persons have injures of brachial artery. Tardy or incompletely dissected circular plaster bandage turned out to be a factor of complication. All patients demonstrated typical clinical aspects of acute circulatory disturbance of extremity, in some of them with skin and subcutaneous fat necrosis. Clinical aspects of contraction during residual period were notable for variety of manifestations and depended upon the depth of tissue affection (muscles, tendons, articulations, vessels, bones). The gravity of disease has been aggravated by affection of nerve trunks (66 patients). Roentgenologic picture revealed changes of mutual positioning of articular ends of jointed bones and trophic changes within the bones. Trophic changes were revealed by osteoporosis of different extent, growth disturbances as well as perversion of ossification rate of epiphysis and apophysis of tubular and carpal bones.
本文介绍了对91例Volkmann挛缩患儿的临床情况及X线片的研究。46例挛缩的病因是肱骨髁上骨折，32例是前臂骨折。所有骨折均伴有软组织的严重损伤，部分患者伴有肱动脉损伤。延迟或未完全松解的环形石膏绷带被证明是并发症的一个因素。所有患者均表现出典型的肢体急性循环障碍的临床症状，部分患者伴有皮肤和皮下脂肪坏死。残留期挛缩的临床症状表现多样，取决于组织受累的深度（肌肉、肌腱、关节、血管、骨骼）。神经干受累（66例患者）使病情加重。X线表现显示关节骨端相互位置的改变以及骨内的营养改变。营养改变表现为不同程度的骨质疏松、生长发育障碍以及管状骨和腕骨骨骺和骨突骨化率的异常。
