Volkmann's_contracture

Volkmann's contracture

Volkmann's contracture, 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.

History

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".

Causes

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.

Treatment

Surgery to release the fixed tissues may help with the deformity and function of the hand.

References

External links

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