前臂缺血性肌挛缩症挛缩期的手术方法及其疗效

Treatment of Ischemic Muscle Contracture in Forearm at Contracture-stage

目的:探讨前臂缺血性肌挛缩症挛缩期的手术方法及其疗效.方法:挛缩进行期7例行肘部神经、血管松解术6例,坏死肌肉和神经切除神经移植、肌腱移位术1例;挛缩恢复期10例均行神经松解术.结果:经5个月～20a随访,挛缩进行期7例中,疗效优3例、良2例、可1例,行坏死肌肉和神经切除、神经移植、肌腱移位术1例疗效差;挛缩恢复期10例中,优3例、良3例、可3例、差1例.松解术的优良率为68.8%(11/16).其中疗效较差的5例在晚期再行屈肌起点滑移术,疗效达优1例,良2例,可1例,差1例.经松解术和二期补充性手术,总优良率达87.5%(14/16).结论:积极的神经松解术是前臂缺血性肌挛缩症挛缩期最有效的手术方法.

Objective：To discuss the treatment of ischemic contracture in forearnt at contracture - stage. Methods：The decompression of nerve and vessel in the elbow - joint was applied to 6 cases and the excision of necrosis muscle nerve, nerve - transplantation and tendon shift to 1 ease with isehemic contracture in forearm at contracture - developing stage and nerve - decompression to 10 cases at eontraclure recovering stage. Results： Five months to 20 years＇ follow - up showed that of the 6 cases receiving nerve - vessel decompression at conlraelure - developing stage, the result was excellent in 3cases, good in 2 eases and fair in 1 case;the result was poor in the 1 case who had excision of necrosis muscle nerve, nerve transplantation and leudon shift. For the patients receiving nerve deeompression at conlracture - recovering stage, the result was excellent in 3 case, good in 3 cases, fair in 3 cases and bad in 1 case,with a respond rate of 68.8% （11/16） .The total effective rate reached 87.5% （14/16） through decompress and supplemental operation. Conclusion：The most effective way for treatment of ischemic contracture in forearm is application of nerve deeonlpressiou at contracture stage.