Volkmann ischemic contracture

Changed by Yuranga Weerakkody, 4 Sep 2018

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Volkmann ischaemic contracture

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A Volkmann ischaemic contracture refers to a complex and variable flexion deformity involving distal lumbes (typically the wrist and fingers) resulting from fibrosis and contracture of flexor muscles.

Clinical presentation

The number of deformities can occur where in the upper extremity this includes elbow flexion, forearm ~~muscles~~pronation, wrist flexion, thumb flexion and adduction, digital metacarpophalangeal joint extension, and interphalangeal joint flexion. Affected limb may become dysfunctional, painful and may lose sensibility.

Pathology

It is caused by ischaemic injury to the deep tissues enclosed in tight unyielding osteo-facial compartment often secondary to a neglected acute compartment syndrome.

Location

forearm and wrist: classically described site
ankle and root: uncommon ⁶

-<p>A <strong>Volkmann ischaemic contracture</strong> refers to a complex and variable flexion deformity involving the wrist and fingers resulting from fibrosis and contracture of flexor forearm muscles.</p><h4>Pathology</h4><p>It is caused by ischaemic injury to the deep tissues enclosed in tight unyielding osteo-facial compartment often secondary to a neglected <a title="acute compartment syndrome" href="/articles/acute-compartment-syndrome">acute compartment syndrome</a>.</p>
+<p>A <strong>Volkmann ischaemic contracture</strong> refers to a complex and variable flexion deformity involving distal lumbes (typically the wrist and fingers) resulting from fibrosis and contracture of flexor muscles.</p><h4>Clinical presentation</h4><p>The number of deformities can occur where in the upper extremity this includes elbow flexion, forearm pronation, wrist flexion, thumb flexion and adduction, digital metacarpophalangeal joint extension, and interphalangeal joint flexion. Affected limb may become dysfunctional, painful and may lose sensibility. </p><h4>Pathology</h4><p>It is caused by ischaemic injury to the deep tissues enclosed in tight unyielding osteo-facial compartment often secondary to a neglected <a href="/articles/acute-compartment-syndrome">acute compartment syndrome</a>.</p><h5>Location</h5><ul>
+<li>forearm and wrist: classically described site </li>
+<li>ankle and root: uncommon <sup>6</sup>
+</li>
+</ul>

References changed:

1. L M, Kiran K K, Kc V, Prasad R S. Volkmann's Ischemic Contracture with Atrophic Non-Union of Ulna Managed by Bone Shortening and Transposition of Radial Autograft. J Orthop Case Rep. 2015;5(1):65-8. <a href="https://doi.org/10.13107/jocr.2250-0685.259">doi:10.13107/jocr.2250-0685.259</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27299025">Pubmed</a>
2. Lapuk S & Woodbury D. Volkmann's Ischemic Contracture. A Case Report. Orthop Rev. 1988;17(6):618-24. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/3043326">Pubmed</a>
3. Hovius S & Ultee J. Volkmann's Ischemic Contracture. Prevention and Treatment. Hand Clin. 2000;16(4):647-57. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/11117054">Pubmed</a>
4. Stevanovic M & Sharpe F. Management of Established Volkmann's Contracture of the Forearm in Children. Hand Clin. 2006;22(1):99-111. <a href="https://doi.org/10.1016/j.hcl.2005.12.003">doi:10.1016/j.hcl.2005.12.003</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/16504782">Pubmed</a>
5. Botte M, Keenan M, Gelberman R. Volkmann's Ischemic Contracture of the Upper Extremity. Hand Clin. 1998;14(3):483-97, x. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/9742427">Pubmed</a>
6. Santi M & Botte M. Volkmann's Ischemic Contracture of the Foot and Ankle: Evaluation and Treatment of Established Deformity. Foot Ankle Int. 1995;16(6):368-77. <a href="https://doi.org/10.1177/107110079501600610">doi:10.1177/107110079501600610</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/7550946">Pubmed</a>

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