Observation And Research On The Phalange Flexion Dysfunction Caused By Infusion Leakage

Objective:(1)To evaluate the surgical treatment and analyze the related factors leading to the disease through watching and treating the pediatric patients who suffered from phalange flexion dysfunction caused by infusion leakage.(2)To establish the animal model and analyze the causes of subcutaneous scar formation caused by infusion leakage through different drugs.Methods:(1)Reviewed from September 2014 to December 2016,18 pediatric patients who suffered from phalange flexion dysfunction caused by infusion leakage and which disease had lasted for more than six months were applied in the research.Their subcutaneous scar of opisthenar was excised.They also experienced extensor tendon release procedure and gained guidance of rehabilitation exercises after operation.The joint range of motion before and after operation was compared.(2)32 SPF adult chickens were randomly dividedinto four groups: group A with physiological saline injection,group B with clindamycin + physiological saline injection,group C with benzyl alcohol +physiological saline injection,group D with clindamycin+ benzyl alcohol +physiological saline injection,with 8 rats in each group.The drugs were injected into the chickens’ dorsal subcutis nearby the third metatarsal and metatarsophalangeal joint,for establishing the subcutaneous infusion leakage models.Double feet were injected at the same time,and each side with 5ml drugs.Recorded the changes of the feet’s appearance and observed the gross pathology of the feet’s subcutis as the animals were sacrificed after 28 days.Then the harvested tissue specimens were observed with optical microscope through HE staining and Masson staining.Results:(1)After the follow-up visit that lasted for six months to two years(the average was 20 months),it was found that the average metacarpophalangel joints mobility of the pediatric patients increased.According to TAM functional assessment,five cases were regarded to be excellent,nine to be good and four to be available(no obvious improvement after the operation).(2)In the animal experiments,the joint motions and appearances were normal from group A and B.Both groups of the feet’s subcutis were no hyperplasia.The feet from group C swollen slightly,Local skin necrosis could be healed,no significant limitation of the joint motions.Subcutis had hyperplasia but there was no obvious scar formation.In group D,the feet stayed swollen,repeated necrosis and scab.The joint motions were limited and a large number of scar tissue was formed.Conclusions:(1)Infusion leakage leads to the subcutaneous scar of opisthenar,which is the major reason for phalange flexion dysfunction.(2)Surgery is the only way for the treatment of this disease.After the operation,excise the scar tissue,release the extensor tendon and do rehabilitation exercises.In this way,the phalange flexion can be corrected.(3)Benzyl alcohol may be the main cause of subcutaneous scar formation,and might have the synergistic effect to promote the subcutaneous scar formation with clindamycin.