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无骨折的假性福克曼挛缩导致的严重指深屈肌肌肉粘连：一例报告及文献综述

Severe Flexor Digitorum Profundus Muscular Adhesion by Pseudo-Volkmann's Contracture without Fracture: A Case Report and Literature Review.

作者信息

Kim Jae Woo, Kim Jong Chan, Koh Sung Hoon, Kim Jin Soo, Roh Si Young, Lee Kyung Jin, Lee Dong Chul

机构信息

Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital, Gwangmyeong, Korea.

Department of Plastic and Reconstructive Surgery, National Police Hospital, Seoul, Korea.

出版信息

Arch Plast Surg. 2024 Nov 13;51(6):561-567. doi: 10.1055/a-2398-9052. eCollection 2024 Nov.

DOI:10.1055/a-2398-9052
PMID:39544516
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11560327/
Abstract

Volkmann's ischemic contracture is a condition characterized by permanent ischemic damage to muscles and nerves due to vascular insufficiency, resulting in flexion contractures of the affected limb. In contrast, pseudo-Volkmann's contracture presents with similar clinical features but lacks ischemic damage and has the potential for complete recovery. We report a case of a 39-year-old man who developed failure of extension in the middle and ring fingers of the left hand following blunt forearm trauma from a rolling machine. Despite no skin breakage or fracture, his symptoms progressively worsened over 2 months without treatment. Surgical exploration 2 years later revealed severe adhesions of the flexor digitorum profundus muscle at the myotendinous junction to the ulnar periosteum, with immediate recovery after release. This case highlights pseudo-Volkmann's contracture in an adult without fracture, likely due to blunt trauma causing delayed adhesion formation.

摘要

Volkmann缺血性挛缩是一种由于血管供血不足导致肌肉和神经永久性缺血损伤，进而引起受累肢体屈曲挛缩的病症。相比之下，假性Volkmann挛缩具有相似的临床特征，但不存在缺血损伤且有可能完全恢复。我们报告一例39岁男性病例，该患者因轧机造成的前臂钝性创伤后，左手中环指出现伸展功能障碍。尽管没有皮肤破损或骨折，但其症状在未治疗的情况下2个月内逐渐加重。2年后的手术探查发现，指深屈肌在肌腱结合处与尺骨骨膜严重粘连，松解后立即恢复。该病例凸显了成人无骨折情况下的假性Volkmann挛缩，可能是由于钝性创伤导致延迟性粘连形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/7f0a250a15c6/10-1055-a-2398-9052-i24apr0058cr-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/23fd31ba14e5/10-1055-a-2398-9052-i24apr0058cr-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/48eaa36c3c35/10-1055-a-2398-9052-i24apr0058cr-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/95ff21615569/10-1055-a-2398-9052-i24apr0058cr-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/c5c431d5ebbc/10-1055-a-2398-9052-i24apr0058cr-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/53bf2414b969/10-1055-a-2398-9052-i24apr0058cr-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/7f0a250a15c6/10-1055-a-2398-9052-i24apr0058cr-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/23fd31ba14e5/10-1055-a-2398-9052-i24apr0058cr-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/48eaa36c3c35/10-1055-a-2398-9052-i24apr0058cr-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/95ff21615569/10-1055-a-2398-9052-i24apr0058cr-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/c5c431d5ebbc/10-1055-a-2398-9052-i24apr0058cr-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/53bf2414b969/10-1055-a-2398-9052-i24apr0058cr-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fb/11560327/7f0a250a15c6/10-1055-a-2398-9052-i24apr0058cr-6.jpg

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本文引用的文献

1
Treatment of a neglected flexor digitorum profundus entrapment after closed reduction of both bone forearm fracture: A case report.闭合复位治疗尺桡骨双骨折后被忽视的屈指深肌卡压的治疗：一例报告。
Jt Dis Relat Surg. 2021;32(3):810-813. doi: 10.52312/jdrs.2021.389. Epub 2021 Nov 19.
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Pseudo-Volkmann Contracture: A Case Report and Review of the Current Literature.假性-Volkmann挛缩：一例病例报告及当前文献综述
J Am Acad Orthop Surg Glob Res Rev. 2018 Nov 2;2(11):e031. doi: 10.5435/JAAOSGlobal-D-18-00031. eCollection 2018 Nov.
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THE TREATMENT OF VOLKMANN'S ISCHEMIC CONTRACTURE.
伏克曼缺血性肌挛缩的治疗
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Entrapment of the flexor digitorum superficials in the radius fracture site.
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J Pediatr Orthop. 1998 Jul-Aug;18(4):437-40.
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Adhesions between muscle and bone after forearm fracture mimicking mild Volkmann's ischemic contracture.前臂骨折后肌肉与骨骼之间的粘连，类似轻度Volkmann缺血性挛缩。
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