Volkman’s ischemic contracture seen in:
Correct Answer: Supracondylar fracture of humerus
Description: Ref: Apley's System of Orthopaedics and Fractures, 8th ed.Explanation:Volkmann's ischaemic contractureIt is a permanent flexion contracture of the hand at 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 painfulOn examination the fingers are white or blue and cold and the radial pulse is absent.Any fracture in elbow region or upper arm may lead to Volkmann's ischemic contracture but commonly caused due to supracondylar 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, especi al 1 y flexor digitorum profundus and flexor pollicis longus.The affected muscles become 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 a plaster cast, or compartment syndrome.It is also caused by fracture of forearm bones which cause profuse bleeding from major blood vessels of forearm.TreatmentSurgery 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 he removed and fascia] compartment should he opened fasciotomy in incipient stage.Prevention:Requires restoration of blood HowReduction of compartmenlal pressureManagement:Proper initial splinting of hand in the function positionRelease of forearm flexors:Muscle slideTendon lengthening:Test for intrinsic tightnessFree functional muscle transfer
Category:
Orthopaedics
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