What is Volkmann ischemic contracture?
Volkmann contracture is a deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm. The condition is also called Volkmann ischemic contracture.
Is Volkmann contracture permanent?
The name Volkmann ischemic contracture is self-explanatory. Ischemic refers to the possible etiology, and contracture indicates shortening. This condition is a permanent flexion deformity at the wrist and fingers that results in a claw-like presentation of the hand.
How is Volkmann’s contracture treated?
Treatment
- For mild contracture, muscle stretching exercises and splinting the affected fingers may be done.
- For moderate contracture, surgery is done to repair the muscles, tendons, and nerves.
- For severe contracture, surgery is done to remove muscles, tendons, or nerves that are thickened, scarred, or dead.
What is the most appropriate intervention in a patient with Volkmann’s ischemic contracture?
Progressive Splinting, passive stretching and tendon gliding, as well as massage can be used in mild to moderate cases of Volkmann’s contracture. By the use of an electromyographic device, the patient can train its affected muscles with cooperativity.
What is the earliest indication of Volkmann’s ischaemia?
The clinical presentation of Volkmann contracture includes what is commonly referred to as the five Ps: pain, pallor, pulselessness, paresthesias, and paralysis. Of these, pain is the earliest sign. On physical examination, pain accentuated by passive stretching seems to be the most reliable finding.
Can you reverse a contracture?
Contracture of nervous and vascular structures may limit the ability to lengthen soft tissues after long-standing contracture. Contractures are most easily reversed when they have recently developed but can usually be substantially corrected after months and sometimes even after years.
What is muscle contracture?
A contracture occurs when your muscles, tendons, joints, or other tissues tighten or shorten causing a deformity. Contracture symptoms include pain and loss of movement in the joint. If this occurs, you should seek treatment right away. Doctors can treat contractures with medicine, casts, and physical therapy.
Which nerve is affected in Volkmann’s contracture?
[5] The median nerve is most frequently damaged with forearm compartment syndrome because of its deeper course in the volar forearm, and is often encased by fibrosis in the setting of Volkmann’s ischemic contracture.
Can you reverse contractures?
What does Volkmann’s ischemic contracture mean in medical terms?
Volkmann ischemic contracture is a deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm. Alternative Names. Causes. Volkmann contracture occurs when there is a lack of blood flow (ischemia) to the forearm.
When does a crush injury cause Volkmann contracture?
Volkmann contracture occurs when there is a lack of blood flow (ischemia) to the forearm. This occurs when there is increased pressure due to swelling, a condition called compartment syndrome. Injury to the arm, including a crush injury or fracture, can lead to swelling that presses on blood vessels and decreases blood flow to the arm.
What are the different levels of Volkmann contracture?
There are three levels of severity in Volkmann contracture: Moderate — all fingers are bent (flexed) and the thumb is stuck in the palm; the wrist may be bent stuck, and there is usually loss of some feeling in the hand
How is hypoxia related to Volkmann’s contracture?
Following this trauma, there is a deficit in the arterio-venous circulation in the forearm which causes a decreased blood flow and hypoxia can lead to the damage of muscles, nerves and vascular endothelium. This results in a shortening (contracture) of the muscles in the forearm. The bones are an important factor in Volkmann’s contracture.