Restoration of hand function by transposition of forearm muscles in patients with ischemic contractur

Authors

  • Sergey Strafun
  • Olexey Dolgopolov

DOI:

https://doi.org/10.15674/0030-59872014398-103

Keywords:

ischemia, Volkmann contracture, hand, transposition

Abstract

Ischemic contracture of the hand (ICH) dramatically impairs the function of the limb, and in severe cases completely immobilizes it. Method of surgical treatment of ICH are tendon-muscle transposition. Objective: To analyze the functional results of restoration the function of the ischemic hand after tendon-muscle transpositions. Methods: Outcomes of surgical treatment were investigated in 65 patients with ICC, received medical care at the Department of microsurgery of the upper extremity of the SI «Institute for Traumatology and Orthopaedics of the National Academy of Medical Sciences of Ukraine» in 1996–2013. Patients were at the end of the reactive-reduction period of ICH and in the residual one. Results: Application of transposition in the treatment of patients with ICC requires a differentiated approach taking into account the period of ischemic process, its severity, and functional disorders. Indications for definite transposition depended on the functional disorders of the ischemic hand and muscle opportunities. In case of manual testing of muscle function should be not less than M4. In needle electromyography spontaneous denervation activity must be absent. Parameters of motor unit potentials during voluntary contraction should be more than 20 % of normal. The most common surgical procedure in patients with mild ICH was tenotomy of thenar muscles. In cases of moderate ICH we more often performed transposition of the superficial flexor tendons onto the deep flexor tendons of the fingers of the hand. The key point to achieving a positive functional result was the restoration of hand grips in the residual period of ICH. Conclusion: The transposition of forearm muscles in cases of ICC are operations allowing you to restore the function of a limb. To obtain a positive result it is necessary to achieve functional stability in the wrist joint and to get the maximum possible amount of passive movements of the fingers joints.

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How to Cite

Strafun, S., & Dolgopolov, O. (2014). Restoration of hand function by transposition of forearm muscles in patients with ischemic contractur. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 98–103. https://doi.org/10.15674/0030-59872014398-103

Issue

No. 3 (2014)

Section

ORIGINAL ARTICLES

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Copyright (c) 2014 Sergey Strafun, Olexey Dolgopolov

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