Volkmann's syndrome , also called Volkmann's contracture or ischemic contracture , is a kind of muscle degeneration caused by the ischemia and accompanied by the necrosis of nerves. This condition is caused by a traumatic ischemia of the limb. These changes are progressive and occur mainly along with the long bone fractures , usually in the upper limb ( supracondylar fracture of the humerus in the extensor mechanism , accounting for approximately ¾ of cases and, less commonly, breaking the bones of the forearm ) . Often it is also the result of too tight plaster cast which may compress the blood vessels and nerves. If the pressure lasts about 5-10 hours , it results in irreversible changes in the muscle , but after 3-6 hours the irreversible changes occur in the nerves
Among others, less frequent causes of Volkmann's syndrome are the sprains, bruising , damage to the artery which causes ischemia . Volkmann's contracture may also affect the lower limb but less frequently than the upper limb. It is then primarily caused by supracondylar femur fractures or tibia fracture.
The initial symptoms of ischemic contracture is a persistent burning pain, accompanied by a livid discoloration of fingers and their swelling, as well as tingling and numbness. In addition, there is a limited mobility in the fingers and hand and disturbance of bathyesthesia , that is, deep sensibility as well as and proprioceptive sensibility in this area. The radial artery pulse is barely palpable. Along with the progression of degenerative changes appearing as a result of Volkmann's syndrome, the contractures and fibrosis of the muscles affected by ischemia occur. Fingers are set in the flexion position in the interphalangeal joints and in hyperextension in metacarpophalangeal joints , whereas the thumb is fixed in position of flexion and adduction, and the wrist - in the position of palmar flexion. The skin becomes thin and the decalcification of the bones occur. This syndrome most often affects children about 5-8 years of age.
The therapeutic effect in the case of the occurrence of Volkmann's syndrome should begin as soon as possible and should be aimed at restoring the blood circulation and improve the blood supply to the affected limb.