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Volkmann's contracture is a deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm.
See also: Compartment syndrome
Volkmann's contracture occurs when there is a lack of blood flow (ischemia) to the forearm. This usually occurs when there is increased pressure due to swelling, a condition called compartment syndrome.
Trauma to the arm, including a crush injury or fracture, can lead to swelling that presses on blood vessels and can decrease blood flow to the arm. A prolonged decrease in blood flow will injure 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 cannot straighten. This condition is called a contracture.
In Volkmann's 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's contracture:
The injury that usually causes this condition is an elbow fracture in children. Other conditions that can cause increased pressure in the forearm include:
Jobe MT. Compartment syndromes and Volkmann contracture. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 71.
Hensinger RN. Complications of fractures in children. In: Green NE, Swiontkowski MF, eds. Skeletal Trauma in Children. 4th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 6.
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