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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. Causes

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. A prolonged decrease in blood flow injures the nerves and muscles, causing them to become stiff (scarred) and shortened. When the muscle shortens, it pulls on the joint at the end of the muscle just as it would if it were normally contracted. But because it is stiff, the joint remains bent and stuck. This condition is called a contracture. In Volkmann contracture, the muscles of the forearm are severely injured. This leads to contracture deformities of the fingers, hand, and wrist. There are three levels of severity in Volkmann contracture:

Mild -- contracture of 2 or 3 fingers only, with no or limited loss of feeling

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

Severe -- all muscles in the forearm that both flex and extend the wrist and fingers are involved; this is a severely disabling condition. There is minimal movement of the fingers and wrist


Decreased sensation

Paleness of the skin

Muscle weakness and loss (atrophy)

Deformity of the wrist, hand, and fingers that causes the hand to have a claw-like appearance

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