littler surgery

The internal muscles of the hand include the large and small muscles of the fish and the interosseous muscles and the sacral muscles. When the hand is severely crushed or combined with fracture, hemorrhage, swelling, forearm tubular gypsum is too tight, and the replanted limb is replanted for more than 8 hours, there may be clinical internal muscle contracture and forearm ischemia. Muscular contractures exist simultaneously. When the above causes cause the internal muscle contracture, the metacarpophalangeal joint buckling can occur, the interphalangeal joints are straightened, the palm crossbar is deepened, the straightened thumb is vertically abducted, and the adduction is to the front of the third metacarpal surface. This phenomenon is called "Intramuscular positive deformity of the hand. Since the interaction between the interosseous muscle and the sacral muscle is the interphalangeal joint of the metacarpophalangeal joint, when the second muscle is contracted or stressed, a positive sign of the intrinsic muscle tension test may occur clinically. That is, when the metacarpophalangeal joint is passively stretched, the interphalangeal joint cannot be flexed, and when the metacarpophalangeal joint is passively flexed, the interphalangeal joint can flex. This deformity will seriously affect the grip function of the hand. Treatment of diseases: congenital multiple joint contracture Indication Mild contracture, when the metacarpophalangeal joint is completely extended, the proximal interphalangeal joint cannot flex, and the inner muscle tension test is positive. In this case, Littler surgery is often needed to release the distal intrinsic muscle to restore the flexion function of the interphalangeal joint. Littler surgery can be performed on any finger. Contraindications The intrinsic loss of muscle function in the hand. Surgical procedure 1. Make a longitudinal incision in the medial aspect of the metacarpophalangeal joint to the dorsal metacarpophalangeal joint. This incision can better expose the transverse or oblique fibers on both sides of the extensor tendon cap. 2. Excision of oblique fibers: The incision flaps are separated to the sides to reveal the extensor tendon membranes on both sides. The oblique fibers of the extensor device are cut parallel to the extensor tendon next to the extensor tendon. Until the point of the extensor tendon is removed, and the separation is completely removed. The interphalangeal joints, such as the interphalangeal joints, can be fully flexed, and the metacarpophalangeal joints are not too stretched, indicating that the resection is appropriate, the wound can be closed.

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