ABSTRACT
The results of operative treatment of 8 patients was analyzed, in whom the lower extremity amputation on the upper third of the shin was performed for severe stage of the ischemic foot contacture. Operative interventions is expedient to perform in a specialized stationary, were exists possibility of further prosthesis. It is necessary to perform the extremity amputation in a residual period of the foot ischemic contracture, when operations for restoration of the sole sensitivity are nonperspective as well as in presence of severe trophic disorders on the sole and the shin, but without purulent--necrotic signs. Confirmed data of clinic--instrumental investigations for chronic course of the ischemic process constitutes an absolute indication for operation.
Subject(s)
Amputation, Surgical , Foot Deformities, Acquired/surgery , Foot/surgery , Ischemic Contracture/surgery , Adult , Aged , Aged, 80 and over , Amputation, Surgical/methods , Blood Flow Velocity , Female , Foot/blood supply , Foot/innervation , Foot Deformities, Acquired/diagnostic imaging , Foot Deformities, Acquired/pathology , Humans , Ischemic Contracture/diagnostic imaging , Ischemic Contracture/pathology , Male , Middle Aged , Necrosis , Radiography , UltrasonographySubject(s)
Fluid Therapy/adverse effects , Hand/blood supply , Ischemic Contracture/etiology , Resuscitation/methods , Adult , Diagnosis, Differential , Humans , Infusions, Intravenous/adverse effects , Ischemic Contracture/diagnostic imaging , Ischemic Contracture/surgery , Male , Resuscitation/adverse effects , Subcutaneous Tissue/surgery , Ultrasonography, Doppler, DuplexABSTRACT
Calcific myonecrosis is an uncommon late sequela of limb trauma that results in calcification and necrosis of damaged muscle. It almost exclusively occurs in the lower extremity. We present a second case of calcific myonecrosis in the upper extremity.
Subject(s)
Calcinosis/diagnostic imaging , Ischemic Contracture/diagnostic imaging , Muscular Diseases/diagnostic imaging , Necrosis/diagnostic imaging , Upper Extremity/physiopathology , Aged , Calcinosis/pathology , Female , Follow-Up Studies , Humans , Ischemic Contracture/physiopathology , Magnetic Resonance Imaging/methods , Monitoring, Physiologic/methods , Muscular Diseases/pathology , Necrosis/pathology , Rare Diseases , Risk Assessment , Severity of Illness Index , Tomography, X-Ray Computed/methods , Upper Extremity/diagnostic imagingSubject(s)
Aneurysm, False/etiology , Fracture Fixation, Internal/adverse effects , Ischemic Contracture/etiology , Olecranon Process/injuries , Ulna Fractures/surgery , Ulnar Artery/surgery , Accidental Falls , Aged , Aneurysm, False/physiopathology , Aneurysm, False/surgery , Angiography , Bone Wires/adverse effects , Chronic Disease , Elbow Joint/surgery , Female , Fracture Fixation, Internal/instrumentation , Humans , Ischemic Contracture/diagnostic imaging , Ischemic Contracture/surgery , Recovery of Function , Regional Blood Flow , Reoperation/methods , Treatment Outcome , Ulna Fractures/diagnostic imaging , Ulnar Artery/diagnostic imaging , Vascular Surgical Procedures/methods , Elbow InjuriesABSTRACT
BACKGROUND: "The terrible disability of irreversible ischaemic flexion contracture of the metacarpi and digits known as Volkmann's contracture can be avoided in the vast majority of cases, but never completely cured" (M. Koszla). A modification of Colzi's forgotten technique for the treatment of Volkmann's contracture is presented together with our treatment outcomes. MATERIAL AND METHOD: The Colzi procedure was performed in 15 patients aged: 3-54 years with Buck-Gramcko grade III, III/IV and IV Volkmann's contractures. Time between injury and surgery ranged from 4.5 months to 21 years. The main manoeuvre to reduce the contracture was two-level shortening osteotomy in the proximal and distal thirds of the radius and ulna. Osteosynthesis was performed by Rush intramedullary nailing. RESULTS AND CONCLUSIONS: A very good range of mobility (from 17 degrees preop. to 56 degrees postop.), force (0.73 preop.- 7.6 kg postop.) and contracture correction (183 degrees preop. - 27 degrees postop.) was achieved. Complications in the form of delayed union or secondary fractures occurred in 4/15 patients, and were managed by prolonged immobilisation and decortication with bone grafting. The modified Colzi procedure proved its value as a universal, easy, minimally invasive and safe method of treatment of Volkmann's contracture regardless of patient age, duration of illness, previous therapy, and stage of contracture.
