چکیده:
Nazila AkbarFahimi PhD Student, Fereydoun Layeghi MD, University of Social Welfare and Rehabilitation Science, Tehran, Iran Abstract The acute compartment syndrome of the forearm is rare and may therefore be easily missed. Although many clinicians will not see such a patient during their entire career, profound knowledge of the symptoms is required to recognize the syndrome in time. Besides immediate identification of the compartment syndrome early surgical treatment is mandatory to avoid its devastating consequences. Then the functional results can be good, but it can't be correct in child because of more chance to survive necrotic muscle and regain motion with splinting and hand therapy. This study reported the nonsurgical treatment for ischemic contracture of hand and forearm due to displaced supra-condylar fracture of the humorous at 6 years old boy, after fixed contractures. [1] All corresponding to: Dr. Seyed Ali Hosseini. E-mail: s_alihosseini@hotmail.com
خلاصه ماشینی:
History Richard von Volkmann in 1881, was one of the first to describe ischemic muscle paralysis and contracture Before this, a few case reports of hand and wrist deformity following injury had been described(1,2) ; however, paralysis and contracture were attributed to neurologic injury (2).
The recognition and treatment of acute compartment syndrome have greatly diminished the incidence and severity of Volkmann’s ischemic contracture Volkmann’s ischemic contracture is the end result of prolonged ischemia of the muscles and nerves in an extremity.
Perhaps the most commonly used classification system is that of Tsuge (36) He classified established Volkmann’s contracture into mild, moderate, and severe types, according to the extent of the muscle involvement.
Treatment Acute compartment syndrome should be treated with emergent fasciotomy as soon as the condition is identified Nonsurgical management Nonsurgical management should be instituted early in most cases of established Volkmann’s contracture.
/ Iranian Rehabilitation Journal ۶٣63 fig 3, first sensory evaluation in median nerve distribution we have loose of protective sensation and other area we have residual deep pressure IN elbow he had 60 degree extension lag and 120 degree active and 130 degree passive flexion as shown in figures4,5 Fig 4-5 , hand apearance in first visit look at clawing position According to evaluation he was in type 2 Zancolli and moderate type of TSUge. Treatment plan Maintain of passive joint motion and preservation and strengthening of remaining muscle function, and correction of deformity through a program of splinting , sensory reeducation (it is expected to be regenerate in moderate cases)muscle reeducation were our treatment goals.