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Volkmann´s Ischemic Contracture에 있어서 Splint 治療 Splint treatment for Volkmann´s ischemic contractore

대한재활의학회지 1977년 1권 2호 p.82 ~ 83
李康穆, 金光會,
소속 상세정보
李康穆 (  ) 
漢陽大學校 醫科大學 再活醫學科

金光會 (  ) 
漢陽大學校 醫科大學 整形外科

Abstract


A case of Volkmann´s ischemic Contracture which was treated with a specially designd finger. flexor stretching splint. A severe Volkmann´s ischemiccontractracture was developed in 7 years old Korean boy with supracondylar fracture of left humerus (photo. 1)..
Physical examination showed severe shortness of the long flexors of the fingers and the thumb with stony hard induration of the muscles. Another finding was weakness of the thenal and, the intrinsic muscles of the hand. The later finding was evaluated by EMG to .-be -profound denervation. This is an evidence of the left median and the ulnar nerve involvement addition to the forearm muscle damage.
Treatment were consisted with electric stimulation therapy to the denervated muscles, heat and massage to soften the indurated muscles. This was followed by the specially designd finger flexor stretching splint as shown in photo. 2. The splint was applied in the fingers extended and the wrist flexed. To extend fingers fully, the wrist had to be flexed (more than 60 degrees in the early stage of the treatment). Gradual wrist extension was carried out by elongating a bar underneath the splint by turning a screw attached. A caution had to be done to prevent a pressure sore on the tip of the fingers.
Gradual improvement was obtained in lengthening the shortend muscles, After 4 week´s treatment, patient could extend fingers almost straightly as photo.3 shows. at this time, there was neural improvement in the median nerve and the ulnar nerve.
I have treated 3 cases of Volkmann´s contracture with the same kind of treatment previously. Satisfectory results were obtaind in all cases. I am sure there are reports about similar splint treatment to Volkmann´s ischemic contracture even though I have not met the
reports.

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