[原著]ハブ咬傷によるIntrinsic plus 拘縮の病態と治療法

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The entity of intrinsic plus contracture of the hand was first described by Bunnell and he termed it Ischemic contracture, Local, in the hand. Though it is uncommon, we have often experienced this contracture as a sequela of Habu snake bite. During past five years, we have expeienced 20 cases 21 hands of intrinsic contracture due to Habu snake bite, Which was quite characteristic and different from due to ischemia. We concluded that degree of contracture was severe in digit which was close to bitten site and contractured digit was deviated toward bitten site. Theoretically, it is considered that complete releasing of intrinsic muscle make clawhand, and Harris emphasized transverse fibers of intrinsic muscle must be preserved. But in our experience, if the contracture is severe and passive hyper extension of M.P. joint is limited, even transverse fibers and volar capule of M.P. joint must be released.