McLardy-Smith P, Burge P D, Watson N A
J Hand Surg Br. 1986 Feb;11(1):65-7. doi: 10.1016/0266-7681(86)90016-1.
A case is described of bilateral ischaemic contracture of the intrinsic muscles of the hands, presenting in a mentally-disturbed patient one year after a reported period of immobilisation in a physical restraint device. Involvement of the deep thenar muscles and the interossei on the radial side of the hand can be explained by consideration of the anatomy of the deep palmar arch. Division of the tendons of the contracted interosseous muscles proximal to the metacarpophalangeal joints and release of the left first web improved hand function. Those who supervise the use of physical restraint devices should be aware of the risk of intrinsic muscle ischaemia and of the need for prompt diagnosis and treatment.
本文描述了一例手部内在肌双侧缺血性挛缩病例，该病例发生在一名精神障碍患者身上，据报告其在使用身体约束装置固定一年后出现此症状。考虑到掌深弓的解剖结构，可解释手部大鱼际深层肌肉和桡侧骨间肌的受累情况。在掌指关节近端切断挛缩的骨间肌肌腱，并松解左手第一指蹼，改善了手部功能。使用身体约束装置的监管人员应意识到内在肌缺血的风险以及及时诊断和治疗的必要性。
