, also known as Volkmann's ischaemic contracture
, is a permanent flexion contracture
of the hand
at the wrist
, resulting in a claw-like deformity of the hand and fingers.
It is named after Dr. Richard von Volkmann
(1830 - 1889), the 19th century German doctor who first described it, in a paper on "non-Infective Ischemic conditions of various fascial compartments in the extremities"
Volkmann's contracture results from acute ischaemia
of the muscles of the forearm
. It is caused by pressure on the brachial artery, possibly from improper use of a tourniquet
, improper use of a plaster cast
or from compartmental syndrome
. It is commonly described in supracondylar fracture of the humerus where it results in injury/occlusion of the brachial artery.
Fibrosis and contracture of the flexor compartment pulls the fingers into flexion and the wrist into flexion and pronation. However, active extension of the fingers is possible when the wrist is passively flexed indicating that the contracture is in the forearm. Damage to the median nerve may result.
Surgery to release the fixed tissues may help with the deformity and function of the hand.