The Early Decompression And Release Of The Nerves In Volkmann's Ischemic Contractures Of The Forearm

Objective: To investigate the optimal time and effect of Volkmann's contracture of forearm through anatomical and early decompression and releases of the nerves. Method: The nutrient vessels were exposed on 6 cadaveric forearm specimen of adult with vessels irrigation. From January 1999 to October 2005, 49 cases of Volkmann's Islamic contracture of the forearm were early operated. There were 31 males and 18 females the age of this group ranged from 3 to 32 years old, with an average of 17.6 years. The causes of injury included distal shaft humerus fracture external fixation with cast in 6 cases, humerus artery injury by supracondylar fracture in 17 cases, both-bone forearm fracture external fixation with cast in 10 cases, single-bone forearm fracture external fixation with cast in 8 cases, dislocation of elbow in 3 cases, forearm soft tissue injured in 5 cases. Volkmann's ischemic contractures classified by Tsuge 3 grades: I type 9cases, II type 29 cases III type 11 cases. The extent of hand muscle contracture was observed and the relationship between the restoration of hand sense function and the intervals from injures to the operation was explored. Result: The nutrient vessels were distributed around the pronator teres muscle and flexor carpi ulnaris muscle. All cases were reviewed. The follow-up for 6month's to 5 years. The result of 15 cases was excellent (S3M4), 19 good (S3M3), and 11 fair (S2M2), 4 bad (S1M2). The percentage of being excellent and good was...