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A. Volkmann

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  Volkmann's contracture , also known as Volkmann's ischaemic contracture , is a permanent flexion contracture of the handat the wrist, resulting in a claw-like deformity of the hand and fingers. It is more common in children. Passive extension of fingers is restricted and painful. [1]  On examination the fingers are white or blue and cold and the radial pulse is absent. Causes  Any fracture in elbow region or upper arm may lead to Volkmann's ischemic contracture but commonly caused due tosupracondylar fracture   of the   humerus. Volkmann's contracture results from acute   ischaemia/necrosis   of the muscle fibres of the flexor group of    muscles of the forearm, especially   flexor digitorum profundus   and   flexor pollicis longus   which becomes fibrotic and short. It is caused by obstruction on the   brachial artery   near the elbow, possibly from improper use of a   tourniquet, improper use of aplaster cast, or    compartment syndrome. It is also caused by fracture of forearm bones which cause profuse bleeding from major blood vessels of forearm. Treatment Surgery to release the fixed tissues may help with the deformity and function of the hand.  All splints, plaster and bandages that might be obstructing the circulation should be removed and fascial compartment should be opened fasciotomy( in incipient stage. Prevention:    requires restoration of blood flow;    reduction of compartmental pressure Management:    proper initial splinting of hand in the function position;    release of forearm flexors;    muscle slide    tendon lengthening;    test for intrinsic tightness    free functional muscle transfer   fasciotomy surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of  circulation to an area of  tissue or  muscle. [  

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Mar 5, 2018

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