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Volkmann’s ischemic contracture

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Ischemic contracture

Symptoms:

The hallmark symptom is pain that does not improve with rest or non-sedating pain medications, and will continue to get worse with time. If the pressure is allowed to persist, there will be decreased sensation, weakness, and paleness of the skin.

Signs and tests:

Typical physical exam findings include severe pain when a muscle is passively moved. For example, when the doctor moves the fingers up and down in a patient with compartment syndrome in the forearm, the patient will experience severe pain. The forearm may be tensely swollen and shiny. There is also pain when the forearm is squeezed.

The test that will absolutely diagnose this condition involves directly measuring the pressure in the compartment by inserting a needle attached to a pressure meter into the compartment. When the compartment pressure is greater than 45 mmHg or when the pressure is within 30 mmHg of the diastolic blood pressure (the lower number of the blood pressure), a diagnosis of compartment syndrome is made.

Once established, someone with Volkmann's ischemic contracture will have his or her fingers and possibly wrist stuck in flexion.

• Review Date: 9/26/2006
• Reviewed By: Andrew L. Chen, MD, MS, Orthopedist, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network.

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