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A-1022 Lumbrical plus or paradox finger extension syndrome - case report and review of the literature
Andreas Gohritz, Dirk J. Schaefer, Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, University Hospital, Basel, Switzerland
Thursday, June 14, 2018 · 9:35 a.m. · 08m 58s
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00:00:00
bring your colleague thank you very much for the opportunity to present
00:00:04
your case off a lambda calculus of paradox thing extension syndrome
00:00:11
um for the adaptation that was a twenty six year old plumber yeah
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and he had a severe contusion office left hand and he could not flexes little thing anymore
00:00:25
so maybe i can activate it later so we had a
00:00:30
paradox extension finger syndrome whenever he wanted to close his hands and
00:00:39
he had three surgical procedures uh prior to uh coming to
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our clinic and she was off work for four years
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and i have to admit i have i had seen that problem
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once it if you have seen it once it's very easy
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to recognise if you have never seen it probably it's difficult
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um so i would like to connect activated again
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for for for for a good
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uh_huh
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avoiding
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so we cannot next week and just
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flex the other thing that's
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and this is a rather rare syndrome um it was described by parks
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and the paradox extension occurs during a tempted
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i think affliction because um the
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contraction of the injured all start deep flex a
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tendon transmits a a viable lumber cull muscle
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and the longer come mostly is flexing and m. c. p. and extending in the uh
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p. i. p. and t. i. p. voice yeah i mean anything to our tomorrow
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so how does it know tone and uh start when i click on it but it's
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um so um because this patient um
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we were not sure if use simulating a um and we
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blocked him before while ultrasound guided grade enough block
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and then he had no extrinsic thing extension anymore and he could not fake
00:02:31
so we saw that he's not simulating and then we did the surgical
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procedure uh using they land and um yeah that was here
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sorry
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also extend how things yeah
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yeah yeah
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one boy again r. s. i. how
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okay so we did an additional new releases and um
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after that he was a able to uh undergo echo therapy
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for coronation uh training and she fully recovered his
00:03:18
a phase closure and he could be reintegrate into work within
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three weeks after being out of work for four years
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so just to a summarise the literature um
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lawmaker plus mostly occurs after rather simple
00:03:35
and increase like contusions fractures so i think
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uh probably it's a hundred diagonals
00:03:42
um syndrome because they only thirty three cases reported in literature
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there's only one larger serious with eighteen fingers the others are a case reports
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and the other therapies very easy you usually respect the lumber
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cull muscle or release it uh or you realise that
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start that the interconnected with the uh deep of a finger flex a ten
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so
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in conclusion it might be really yeah syndrome but every hand surgeon should be aware of this
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probably not so rare yeah post traumatic disorder and
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if you recognise them uh start your straightforward therapy uh
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so three and you can reintegrate the patient a rapidly into his professional and they like thank you
00:04:40
how are any questions
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or less
00:04:50
thank you for the presentation that i want to ask uh what did you do did mention the the news with
00:04:56
but these i'm sorry how did you do the definition of the movies
00:05:01
we could be using six buttons and they didn't because last
00:05:06
oh yeah no uh he uh during the surgery he actually
00:05:10
he could activated after i respected the longer cool
00:05:14
i put on the line recall and then uh made uh to the license and rejected it and then he was able to flex
00:05:21
until here about and then because you have three previous operations here in
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the last last thing you want a uh he had additional
00:05:30
tend annotations and then i didn't really attend a license in any was able
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to like like this with his coordination problems afterward flexing
00:05:39
for four years and then he he underwent
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uh occupational therapy and special training and you could make clothes it's just
00:05:51
uh_huh
00:05:57
i
00:06:01
excuse me but do you need the f. t. p. easy for the american people so long
00:06:09
no it's it's i think it's not um
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you don't need a he had no a lesion for example get the just the c. d. a contusion
00:06:20
of his hand and he had a of a fourth met a couple fracture and
00:06:26
also uh sylvia contusion of his little finger ray and uh that probably
00:06:31
cost the s. r. i. t. asian between his f. p. l. and uh
00:06:38
the lumber cool muscle that's a classic case as it was um
00:06:44
first describe but i think uh it's uh the mechanism is
00:06:48
that you have and some kind of interconnection or um
00:06:53
just a function of the f. p. l. or the interconnection was stars uh between after the number call
00:07:00
must continue to use the human genome soaking up with you in
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the immediate was self employed him oh i just don't
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um actually uh there was there was every kind of imaging
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done before include inclusive m. r. i. office brain
00:07:19
and that was the moment when i step in because um i heard the call and
00:07:24
they were talking about yeah yeah something is preying on the right side but then the colleagues at yeah but while the
00:07:30
right set it should be on the other side because they have this crossing and this okay yeah that's right
00:07:36
and then i would i would i became knows the and i looked at it and yeah i had seen it before so i
00:07:43
was prepared
00:07:48
the that's a that's a very good question we were not so advanced at
00:07:53
that time with the ultrasound we're we have unpacked dissing now more
00:07:58
probably you if if you have the suspicion you could probably recognise it yet
00:08:05
but he had like into ten different places before or repeatedly to same
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they had done as i said
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yes of therapy three operations samurai is everything
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in which can be in a in a hand management whiny
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you need to really see me nice and do
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he's not is easy and me just getting in the can
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when when you're least likely to lease it need mm yeah it was my first operation of that kind and since
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then the only one and it is described as a re section but you could also just cut it
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