Objective To summarize the current research progress of finger flexion deformity caused by forearm flexor muscle lesions, providing a reference for clinical diagnosis and treatment. Methods The domestic and international literature about finger flexion deformity caused by forearm flexor muscle lesions was extensively reviewed and a summary analysis from the etiology and pathogenesis, diagnosis and differential diagnosis, and treatment methods was conducted. Results The three types of forearm flexor pathology leading to finger flexion deformity include Volkmann’s contracture, pseudo-Volkmann’s contracture, and congenital flexor muscle lesions with different pathogenesis. The diagnosis is mainly based on the patient's medical history, clinical features, and imaging examinations, with attention paid to differential diagnosis. Currently, conservative treatment for such deformities is not very effective, and surgical treatment is mainly adopted. According to the causes and severity, options such as resection of the contracture band, resection of contracture band, release of compressed muscle (tendon), and flexor origin muscle sliding surgery, could be performed to correct hand deformities and restore hand function, and thus resulting in favorable outcomes. Conclusion Volkmann’s contracture, pseudo-Volkmann’s contracture, and congenital flexor muscle lesions causing finger flexion deformity have different causes and pathogenesis, which can be distinguished by carefully inquiring about the medical history, the clinical characteristics of the three, and imaging examinations, thereby selecting appropriate treatment methods.
Objective
To provide the anatomical basis of contralateral C7 root transfer for the recovery of the forearm flexor function.
Methods
Thirty sides of adult anti-corrosion specimens were used to measure the length from the end of nerves dominating forearm flexor to the anastomotic stoma of contralateral C7 nerve when contralateral C7 nerve transfer was used for repair of brachial plexus lower trunk and medial cord injuries. The muscle and nerve branches were observed. The length of C7 nerve, C7 anterior division, and C7 posterior division was measured.
Results
The length of C7 nerve, anterior division, and posterior division was (58.8 ± 4.2), (15.4 ± 6.7), and (8.8 ± 4.4) mm, respectively. The lengths from the anastomotic stoma to the points entering muscle were as follow: (369.4 ± 47.3) mm to palmaris longus, (390.5 ± 38.8) mm (median nerve dominate) and (413.6 ± 47.4) mm (anterior interosseous nerve dominate) to the flexor digitorum superficialis, (346.2 ± 22.3) mm (median nerve dominate) and (408.2 ± 23.9) mm (anterior interosseous nerve dominate) to the flexor digitorum profundus of the index and the middle fingers, (344.2 ± 27.2) mm to the flexor digitorum profundus of the little and the ring fingers, (392.5 ± 29.2) mm (median nerve dominate) and (420.5 ± 37.1) mm (anterior interosseous nerve dominate) to the flexor pollicis longus, and (548.7 ± 30.0) mm to the starting point of the deep branch of ulnar nerve. The branches of the anterior interosseous nerve reached to the flexor hallucis longus, the deep flexor of the index and the middle fingers and the pronator quadratus muscle, but its branches reached to the flexor digitorum superficials in 5 specimens (16.7%). The branches of the median nerve reached to the palmaris longus and the flexor digitorum superficial, but its branches reached to the deep flexor of the index and the middle fingers in 10 specimens (33.3%) and to flexor hallucis longus in 6 specimens (20.0%).
Conclusion
If sural nerve graft is used, the function of the forearm muscles will can not be restored; shortening of humerus and one nerve anastomosis are good for forearm flexor to recover function in clinical.
