Some Experiences of Tendon Rearrangement for Late Stage of Volkmann's Ischemic Contractures Reports 8 Cases

Jeong, H Y; Lee, H K; Seoh, M S; Shin, H C

Abstract

Volkmanns contracture is characterized by ischemic necrosis of the structures contained within the volar compartment of the forearm, usually following a severe injury about elbow or directly to the forearm, eventuating in crippling contractures often associated with varying degrees of a neurologic deficits. We have known that the pathomechanics of the hand deformity in Volkmanns contracture are complex and the management including its prevention, early recognition, prompt treatment, as well as the reconstruction of established contractures requires great skill on the part of the orthopedic surgeon. We have classified 8 cases of the late stage of the Volkmanns ischemic contracture respectively by Zancollis type, depend on their intrinsic muscle condition and reconstructed them with tendon rearrangement from May 1979 to February 1982. The results were obtained as follows: l. It is shown that good results from tendon transposition of flexor digitorum profundus to each flexor digitorum sublimis, in the case of intact flexor sublimis. 2. It is possible to be recovery of hand function by tendon transposition of extensor carpi radialis longus to flexor digitorum profundus and brachioradialis to flexor pollicis longus, at a time, in the case of involved both flexor digitorum profundus and sublimis. 3. Concerning additional operation, there were Z-lengthening of flexor carpi radialis, ulnaris and flexor pollicis longus with complete neurolysis. 4 .It is possible to be made hand function in Type I and Type II by Zancollis method.