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Volkmann Ischemic Contracture

Reviewed 06/2021
 


BASICS

DESCRIPTION

An irreversible flexion contracture at the wrist following ischemic injury (most commonly from compartment syndrome): 
  • Compartment syndrome occurs when the pressure within the closed ...

DIAGNOSIS

HISTORY

  • Trauma; fracture

  • Tourniquet use

  • Prior compartment syndrome

  • Arterial embolus

  • Burns

  • Muscle hypertrophy/overtraining of upper extremities

  • Overly tight bandages/dressings

  • Snake bite or insect st...

TREATMENT

GENERAL MEASURES

The only appropriate treatment for acute compartment syndrome is surgical release with fasciotomy. 
  • Failure to diagnose or treat compartment syndrome can lead to irreversible ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Physical and occupational therapy to maximize limb function

  • Follow-up with orthopedic surgeon to determine the need for surgical revision (6)[B]: http://hprc-onli...

REFERENCES

1
McDonald  S, Bearcroft  P. Compartment syndromes. Semin Musculoskelet Radiol.  2010;14(2):236–244. [View Abstract on OvidMedline]
2
...

ADDITIONAL READING

  • Blakemore  LC, Cooperman  DR, Thompson  GH, et al. Compartment syndrome in ipsilateral humerus and forearm fractures in children. Clin Orthop Relat Res. ...

CODES

ICD10

  • T79.6XXA Traumatic ischemia of muscle, initial encounter

  • T79.6XXD Traumatic ischemia of muscle, subsequent encounter

  • T79.6XXS Traumatic ischemia of muscle, sequela

SNOMED

  • 111247001 Volkmann's c...

CLINICAL PEARLS

  • Volkmann ischemic contractures are most common in pediatric upper extremity fractures with associated compartment syndrome.

  • Early diagnosis and surgical decompression prevents this debi...

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