Rubin G, Palti R, Gurevitz S, Yaffe B
Hand Surgery Department, Sheba Medical Center, Tel Hashomer, Israel Faculty of Medicine, Technion, Haifa, Israel
Hand Surgery Department, Sheba Medical Center, Tel Hashomer, Israel.
J Hand Surg Eur Vol. 2015 Jul;40(6):614-9. doi: 10.1177/1753193414528850. Epub 2014 Mar 24.
The purpose of this study is to report our experience with free functional muscle transfer procedures for the late sequelae of the rare condition of congenital Volkmann's ischaemic contracture of the forearm. Four children, with an average age of 9.5 years (range 1.5-17), were treated and were followed for a mean of 6 years (range 1-14). Two patients had dorsal forearm contractures, and two had both flexor and extensor forearm contractures. We carried out free functional muscle transfers to replace the flexor or extensor muscles. The functional result was assessed according to the classification system of Hovius and Ultee. All patients had wrist contractures and skeletal involvement with limb length discrepancy that influenced the outcome. All five transferred muscles survived and improved the function of the hand in three of the four patients. LEVEL OF EVIDENCE 4.
本研究的目的是报告我们对罕见的先天性前臂Volkmann缺血性挛缩晚期后遗症进行游离功能性肌肉移植手术的经验。治疗了4名儿童，平均年龄9.5岁（范围1.5 - 17岁），平均随访6年（范围1 - 14年）。2例患者为前臂背侧挛缩，2例患者同时存在前臂屈肌和伸肌挛缩。我们进行了游离功能性肌肉移植以替代屈肌或伸肌。根据Hovius和Ultee的分类系统评估功能结果。所有患者均有腕关节挛缩和骨骼受累，伴有肢体长度差异，这影响了治疗结果。4例患者中的3例，所有5块移植肌肉均存活并改善了手部功能。证据级别4。
