Kaji Yoshio, Nakamura Osamu, Yamaguchi Konosuke, Tobiume Sachiko, Yamamoto Tetsuji
Department of Orthopaedic Surgery, Kagawa University Faculty of Medicine, Kagawa, Japan.
Medicine (Baltimore). 2017 Jan;96(1):e5807. doi: 10.1097/MD.0000000000005807.
For localized type Volkmann's contracture, in which degeneration of the flexor digitorum profundus (FDP) muscle to one or two fingers and restriction of finger extension occur, dissection or excision of the affected muscle is usually recommended. However, these surgical procedures need relatively wide exposure of the muscle, because the FDP muscle is in the deep portion of the forearm.
In this report, the case of a 35-year-old woman with localized type Volkmann's contracture is presented. Her left forearm had been compressed with an industrial roller 4 months earlier, and severe flexion contracture of the long finger and mild flexion contracture of the ring finger developed gradually. DIAGNOSES:: localized type Volkmann's contracture.
Five months after the injury, transection of the FDP tendon to the long finger and transfer of the transected tendon to the FDP tendon to the index finger was performed after adjusting the tonus of these two tendons using a small skin incision. This procedure was followed by a tension-reduced early mobilization technique in which a tension-reduced position of the tendon suture site was maintained by taping the long finger to the volar side of the index finger, and then immediate active range of motion (ROM) exercise was started.
Within 9 weeks after surgery, full ROM had been regained.
Using the treatment procedure presented in this case report, a good clinical result was obtained in a minimally invasive manner.
对于局限性福克曼挛缩症，即屈指深肌（FDP）一或两根手指发生退变且手指伸展受限，通常建议对受累肌肉进行解剖或切除。然而，由于FDP肌肉位于前臂深部，这些手术操作需要相对广泛地暴露该肌肉。
本报告介绍了一名35岁局限性福克曼挛缩症女性患者的病例。4个月前，她的左前臂被工业滚筒挤压，逐渐出现示指严重屈曲挛缩和环指轻度屈曲挛缩。
局限性福克曼挛缩症。
受伤5个月后，通过一个小皮肤切口调整两根肌腱的张力后，对示指的FDP肌腱进行横断，并将横断的肌腱转移至示指的FDP肌腱。此操作之后采用一种减张早期活动技术，即通过将示指贴于示指掌侧来维持肌腱缝合部位的减张位置，然后立即开始主动活动范围（ROM）锻炼。
术后9周内恢复了完全的ROM。
采用本病例报告中介绍的治疗方法，以微创方式获得了良好的临床效果。
