Volkmann's Contracture

Volkmann's Contracture is a deformity of the arm, wrist, and fingers, caused by an injury to the arm such as a fracture or a crush injury. It causes a lack of blood flow to the forearm, which can lead to muscle problems if it is not dealt with quick enough. Raising the arm and releasing the pressure in the forearm (via surgery) are two main ways to help treat this injury.

Symptoms of Volkmann's Contracture

  • Pain in the forearm, wrist or hand/fingers.
  • Pain doesn't improve with rest or pain medication.
  • Neural symptoms such as tingling, numbness, and weakness.
  • Pale, cold skin.
  • Muscle spasm.
  • Deformity of the wrist and fingers.

Causes

Volkmann's contracture (sometimes called an ischemic contracture) is caused by a lack of blood flow to the forearm. The cause of this is usually an acute injury (such as a fracture or crush injury) to the upper arm or elbow area. This can cause swelling which compresses the blood vessels which supply blood to the forearm and hand. A long-term lack of blood can cause permanent damage to the muscles and nerves.

The muscles in the forearm become shortened and tight, resulting in a contracture. The muscles pull on the joints in the wrist and hands, causing the wrist and fingers to become bent.

This condition is most common in children who fracture the arm, just above the elbow. Although it can also occur due to other injuries, as well as severe burns, reactions to insect bites, injections and anything that causes swelling within the forearm

Treatment

  • If the condition is caused by an acute injury, this should first be treated appropriately.
  • The arm should be raised if possible to reduce swelling in the forearm.
  • The best treatment for Volkmann's contracture is to release the pressure in the forearm as soon as possible via surgery.
  • If not treated early and muscle damage has occurred, surgery may be required to lengthen or even transfer muscles in order to regain function.

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