Professor, Department of Reconstructive and Microsurgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Teharan, Iran , medcenter@sokhan.net
Abstract: (21400 Views)
Background and Aim: The volkmann syndrome is ischimia and muscular necrosis due to pressure augmentation in the closed aponeurotic compartments of the forearm region. The incidence of this syndrome in Iran is more than the normal incidence, since non-medical people perform bandage or casting too tightly, for the treatment of forearm lesions. Materials and Methods: A total of 67 patients, 64 male and three female, ranging in age from 7 to 18 years with the average of 13 years were treated by one of the four methods of Scaglietti, Latissimus dorsi Island flap, Gracilis free muscle transfer or Biceps tendon transfer. Results: From 33 patients with some muscle contracture who underwent flexor muscle advancement (Scaglietti technique) 25 (71.4%) resulted in excellent, and 10 (28.6%) resulted in good outcome. Latissimus dorsi Island flap resulted in 20 (90.9%) excellent, and and 2 (9.1%) good results in total of 22 patients. Gracilis muscle transfer in 4 patients resulted in 4 good outcomes (100%). Six biceps tendon transfer procedure resulted in 6 good outcomes (100%). Conclusion: If some forearm muscle contraction is revealed in the physical examination, good results can be obtained by performing the Scaglietti procedure. We did not have any muscle necrosis of the transferred latisimuss dorsi island flap, or musculocutaneous gracillis free flaps transferred. The transfer of biceps tendon to the digital flexor tendon yields in acceptable results for the patients. But the patient needs good re-education and physiotherapy for adaptation to the new condition.