Current location - Plastic Surgery and Aesthetics Network - Plastic surgery and medical aesthetics - Treatment of ischemic muscle contracture of the forearm
Treatment of ischemic muscle contracture of the forearm

1. Early stage: Once the diagnosis is clear, time should be sought to improve the blood supply of the affected limb, external fixation or dressings should be removed as soon as possible, and the flexed joints should be properly straightened, regardless of fracture alignment. If the blood supply still cannot be improved, decompression and exploratory surgery should be performed immediately (should be performed within 6-8 hours of the onset of the disease). The open wound was not sutured during the operation. After the swelling of the limb subsides, secondary or delayed suturing of the wound can be performed.

2. Use antibiotics throughout the body to prevent infection, pay attention to acidosis, hyperkalemia, toxic shock and acute renal failure caused by the absorption of necrotic substances, and provide appropriate treatment. It is strictly prohibited to elevate or apply heat to the affected limb.

3. Late stage: surgical treatment is the main method. It should be based on the time, scope and extent of the damage.

If the contracture deformity has not stabilized before 6 months, functional exercises and functional brace fixation can be performed at this time. After the deformity has stabilized (at least half a year to one year later), orthopedic and functional reconstruction surgery can be performed. Choose as appropriate: shortening of the radius and ulna, fixation of the wrist joint, carpal bone resection, downward movement of the starting point of the forearm flexor tendon, scar resection, tendon lengthening and tendon transposition, etc. There is also neurolysis. If the median nerve and ulnar nerve are nonfunctional at the same time, the ulnar nerve can be used to repair the median nerve. 1. All patients must be given intravenous antibiotics, and different antibiotics can be selected according to specific circumstances.

2. For complications such as acidosis, corresponding treatment measures should be taken, such as alkali supplementation, symptomatic support and other comprehensive treatments.

3. For those who suffer from shock, excessive intraoperative bleeding or poor physical condition, blood transfusion or human albumin, etc. are required.