[The pathogenic mechanism and prevention and treatment of muscle contracture after replantation of severed palm or wrist].

OBJECTIVE

To explore the pathogenic mechanism of intrinsic muscle contracture after replantation of severed palm or wrist, and put forward the prevention and treatment methods.

METHODS

From 1985 to 1997, 48 cases were received replantation of severed palm or wrist, among them, 9 cases with thumb adductor contracture and 6 cases with intrinsic muscle contracture were occurred in different degree. Two cases with mild thumb adductor contracture were received conservative treatment, and 7 cases with moderate thumb adductor contracture and 6 cases with intrinsic muscle contracture were received operative treatment. The pathogenic mechanism, clinical results, and prevention methods were studied in those 15 cases.

RESULTS

The postoperative function recovery was better in 4 cases, moderate in 5 cases with thumb adductor contracture, and better in 3 cases, moderate in 1 case with intrinsic muscle contracture, and moderate in 1 case, poor in 1 case with intrinsic muscle contracture of cord-like induration. Followed up 1 to 10 years, no recurrence was observed in all of 15 cases. The incidence and degree of thumb adductor contracture and intrinsic muscle contracture were closely related to the ischemia time of replanting graft.

CONCLUSION

Prevention of thumb adductor contracture and intrinsic muscle contracture is most important in severed palm or wrist replantation. When the ischemia time of replanting graft is longer than 12 hours, the effective decompression in myofascial compartment is performed in time to reach satisfactory result.