Research Article| Volume 1, ISSUE 3, P221-227, December 1976

Volkmann's ischemic contracture due to soft tissue injury alone

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      Fifteen upper extremities, in 14 patients in whom incipient or actual Volkmann's ischemic contracture was present, were seen in a 5 year period. Nine patients were stuporous due to drug overdose and had laid on the extremity; two had received a recent injury of main arterial trunks; two had sudden severe compression; one with chronic myelogenous leukemia had each arm involved at different times in a bizarre autoimmune response causing massive swelling. No patient had a fracture or dislocation. Pain and tenderness, loss of sensibility, resistant muscle contracture, and rock-hard muscle compartments were warning signs. Immediate fasciotomy was done. Useful function was restored when treatment was carried out in the early stages of the ischemia.
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        • Hill R.L.
        • Brooks B.
        Volkmann's contracture in hemophilia.
        Ann. Surg. 1936; 103: 444
        • Volkmann R.
        Die Ischaemischen Muskellahmungen und Kontrakturen.
        Zentralbl. Chir. 1881; 51: 801
        • Murphy J.B.
        Myositis: Ischemic myositis: Cicatricial muscular or tendon fixation in forearm: Internal, external and combined compression myositis with subsequent musculotendinous shortening.
        J. A. M. A. 1914; 63: 1249
        • Griffiths D.L.
        Volkmann's ischemic contracture.
        Br. J. Surg. 1940-41; 28: 239
        • Harman J.W.
        A histological study of skeletal muscle in acute ischemia.
        Am. J. Pathol. 1947; 23: 551
        • Harman J.W.
        The significance of local vascular phenomena in the production of ischemic necrosis in skeletal muscle.
        Am. J. Pathol. 1948; 24: 625
        • Harman J.W.
        • Gwinn R.P.
        The recovery of skeletal muscle fibers from acute ischemia as determined by histological and chemical methods.
        Am. J. Pathol. 1949; 25: 741
        • Benjamin A.
        The relief of traumatic arterial spasm in threatened Volkmann's ischemic contracture.
        J. Bone Joint Surg. 1957; 39B: 711
        • Howse A.J. G.
        • Seddon H.J.
        Ischemic contracture of muscle associated with carbon monoxide and barbiturate poisoning.
        Br. Med. J. 1966; 1: 192
        • Orizaga M.
        • Ducharme F.A.
        • Campbell J.S.
        • et al.
        Muscle infarction and Volkmann's contracture following carbon monoxide poisoning: A case report.
        J. Bone Joint Surg. 1967; 49A: 965
        • Conner A.C.
        Prolonged external pressure as a cause of ischemic contracture.
        J. Bone Joint Surg. 1971; 53B: 118
        • Osborne A.M.
        • Dorsey L.R.
        • Harvey J.P.
        Volkmann's contracture associated with prolonged external pressure on the forearm.
        Arch. Surg. 1972; 104: 794
        • Spinner M.
        • Aiache A.
        • Silver L.
        • et al.
        Impending ischemic contracture of the hand.
        Plast. Reconstr. Surg. 1972; 50: 341
        • Wolfort F.G.
        • Cochran T.C.
        • Filtzer M.
        Immediate interossei decompression following crush injury of the hand.
        Arch. Surg. 1973; 106: 826
        • Finochietto R.
        Retraccion isquemica de los interoseos de la mano por traumatismo. Boletines y Trabajos de la Sociedad de Cirugia, Buenos Aires1920
        • Bunnell S.
        • Doherty E.W.
        • Curtis R.M.
        Ischemic contracture, local in the hand.
        Plast. Reconstr. Surg. 1948; 3: 424
        • Eaton R.G.
        • Green W.T.
        Epimysiotomy and fasciotomy in the treatment of Volkmann's ischemic contracture.
        Orthop. Clin. North Am. 1972; 3: 175
        • Eaton R.G.
        Personal communication. 1975;
        • Whitesides Jr., T.E.
        • Haney T.C.
        • Marada M.
        • et al.
        Tissue pressure as a determinant for the need for fasciotomy.
        Orthop. Rev.:. 1975; 11: 37
        • Seddon H.J.
        Volkmann's contracture: Treatment by excision of the infarct.
        J. Bone Joint Surg. 1956; 38B: 152
        • Scagalietti O.
        Sindromi cliniche immediate e tardive de lesion; vasculari nelle fratture degli arti.
        Riforma Med. 1957; 71: 749