ischemic contracture
Introduction
Introduction Due to severe ischemia, the limbs cause muscle necrosis or contracture. Due to nerve ischemia and scar compression, nerve parts are often paralyzed, which makes the limbs severely disabled.
Cause
Cause
This condition often occurs in the upper extremity humeral epiphysis fracture, ulnar and tibial fractures. Causes of muscle ischemia, some because of the small splint or gypsum too tight, affecting venous return and arterial blood supply, and some due to limb arterial compression, vascular rupture, thrombosis and vasospasm.
Examine
an examination
Related inspection
X-ray lipiodol contrast M-mode echocardiography (ME) bone marrow imaging
1, X-ray inspection
(1) The size and shape of the heart image provide an important reference for the diagnosis of the cause of contracture. The degree of cardiac function and the dynamic change also indirectly reflect the state of cardiac function.
(2) The presence or absence of pulmonary congestion and its extent directly reflect the state of cardiac function. When the early pulmonary venous pressure is increased, the main manifestation is the enhancement of hilar vascular shadow. The increase of upper pulmonary vascular shadow is similar to that of lower lung, even more than the lower lung.
Due to the increase of pulmonary artery pressure, the pulmonary artery is widened. Further interstitial pulmonary edema can blur the lung field. The Kerley B line is a horizontal line shadow clearly visible on the outside of the lung field. It is the expression of effusion in the interlobular space of the lung. It is a chronic lung. Characteristic manifestation of congestion. In the case of acute alveolar pulmonary edema, the hilar is butterfly-like, and the lung field shows a large fused shadow.
2, echocardiography
More accurate than the X to provide changes in the size of each heart cavity and heart valve structure and function.
Diagnosis
Differential diagnosis
Contracture refers to the long-term spasticity or a certain position of a muscle or joint, causing muscle atrophy to deform and fix the joint, thereby causing dysfunction of the body and local pain. Due to the etiology, collateral is more common in the elderly, and often occurs in the limbs and nearby joints, which is an important reason that affects the rehabilitation of the disease and reduces the quality of life of the elderly.
Early manifestations of ischemic contracture: the brachial artery pulsation weakens or destroys, the fingers and wrists flex, unable to automatically extend the fingers (bend) and extend the wrist, and passive movement is also restricted and causes pain. The hands and forearms are numb, chilly or painful. If not treated immediately, the muscles become necrotic and form scar contracture.
