Two Cases of Ishaemic Contracture of Intrinsic Muscle in the Hand

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Two cases of ishaemic contracture, local in the hand were reported.Case 1-A woman, twenty year old, had the press-injury on the right wrist. The initial treatment was performed by wound closure and application of a plaster. After application of the plaster the hand was enormously swollen but was neglected to have proper care. After four weeks the plaster was removed and she noticed that the thumb could not be opend for grasping and its metacarpophalangeal joint could not be opend from its slightly flexed position.At operation fibrous degenerated adductus pollicis muscle and flexor pollicis muscle were removed and Z-plasty on the thumb cleft was carried out. Histological changes were the same as in the muscles found in Volkmann's ishaemic contracture.Case 11-A boy of five sustained a supracondylar fracture of the light humerus and was treated with overhead sponge traction. During the treatment swelling of the hand in the too tight elastic bandage was found and formed decubitus on the radial side of the thenar eminence. When the fracture was healed it was noticed that the thumb could not be opend for grasping. On the examination it was confirmed that the adductor pollicis muscle was contracted.It was stressed that prophylactically great care should be used to avoid swelling of the hand or arm in the tight encasement.
西日本整形・災害外科学会の論文