Correction of Severe Contracture of Intrinsic Plus Hand with a Modified Ilizarov Mini-Fixator: Correction with an Ilizarov Mini-Fixator for Severe Hand Contracture

[摘要] Complete flexion contracture of all digits, including the thumb, is rare. The presentation is similar to clenched fist syndrome and it is often associated with various non-psychiatric events such as trauma, malnutrition, and ischemia. It is also often associated with psychiatric pathology. Unlike clenched fist syndrome, its status can worsen over time and result in soft tissue contracture and joint malalignment. The most common type of severe post-traumatic finger contracture is intrinsic minus hand (claw hand) which is caused by an imbalance of traction forces between the extrinsics and intrinsics. In this condition, the former exceeds the latter. Intrinsic plus hand, on the other hand, in which the traction forces of the intrinsics exceed the extrinsics, is rarely observed. Adduction contractures of all five digits are commonly observed in both conditions. Complete flexion contracture of the intrinsic plus hand is quite rare and its treatment is extremely difficult. While this deformity is often due to direct hand trauma, malnutrition, or ischemia, it can also occur without any obvious causes [1, 2]. The differential diagnosis includes the psychoflexed hand, a rare clinical condition with fixed finger contractures whose etiology is undetermined and it is often associated with psychiatric pathology [3–5].

[学科分类] 外科医学

[关键词] External fixator;Intrinsic plus hand;Severe hand contracture