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Hand:
Dorsal interosseus
Volar interosseus
Adductor
Thenar
Hypothenar
Pathophysiology
Any condition that cause a decrease in compartment size or increase
in compartment pressure can initiate compartment syndrome.
Vicious cycle:
the
Clinical Features
Clinical features is based on the classification of the disease:
Classification:
Holden Classification is based on location
Level IInjury is proximal to the ischemia and later contracture
Level IIIschemia is directly under the injury (pressure)
of digital deformity:
I simple digital claw
II opposition paralysis
III intrinsic claw hand
Treatment
Several clinical factor determine the choice of the most adequate surgical
procedure:
1. Type of digital deformity
2. Deformation of carpal bones after growing period
3. Functional condition and degree of retraction of long digital flexor
muscles
4. Sensory impairment
5. Clawhand complications
6. Thumb contracture
Type I
most favour, restoration of hand fracture due to normal intrinsic muscles
& cutaneous sensation
Type II
First stage
o Retracted muscle of the forearm are corrected.
Second stage
o The problem is claw hand
o Active or passive surgical procedure
Lasso zancolli
MCP capsulotomy
Type III
Contracture of the muscle of the forearm and of the intrinsic muscles
must be corrected during the same surgical procedure
o Mild case
Distal intrinsic release classical technique of intrinsic
lateral bands and triangular interosseus lamina excisions
o Cases with flexion contracture of MCP
Proximal intrinsic release interosseus tendon are excised at
the level of the neck of the MCP bone