Volkmann Contracture: Symptoms, Causes, Diagnosis, Treatment

Volkmann contracture, or Volkmann ischemic contracture, is a permanent shortening of your forearm muscles. It causes a “claw-like” posture of your hand, wrist, and fingers.

Volkmann contracture usually results from traumatic injuries that cause acute compartment syndrome of your arm. Acute compartment syndrome is a medical emergency. It occurs when the pressure in a muscle increases dangerously high.

Symptoms of Volkmann contracture can vary depending on the severity of muscular injury. Some people may have only two or three fingers affected, while others have all their fingers and wrist affected.

Let’s examine Volkmann contracture in more detail, including causes, symptoms, and outlook.

What causes Volkmann contracture?

A traumatic injury usually causes Volkmann contracture. The most common injury is a supracondylar fracture of the humerus. This fracture occurs in the lower part of your upper arm bone. The fracture can lead to a medical emergency called acute compartment syndrome.

Acute compartment syndrome occurs when the pressure inside a muscle becomes dangerously high. This often causes severe pain. It requires immediate medical attention.

Any other cause of acute compartment syndrome can potentially result in Volkmann contracture. Other causes include:

• animal bites
• tight bandages and dressings
• burns
• increased muscle size
• intensive and extensive exercise
• tumors
• bleeding into a compartment in your arm
• injections in your forearm
• forearm surgery complications
• soft tissue injury

Volkmann contracture can also result as a complication of acute arterial insufficiency. This is when part of your body loses its blood supply. A type of blood clot called an arterial embolism usually causes it.

Volkmann contracture appears to be most common in males in their 20s.

Pseudo-Volkmann contracture

Pseudo-Volkmann contracture is a condition that causes similar symptoms to Volkmann contracture but has a different root cause. Pseudo-Volkmann contracture happens from the entrapment of tendons in your forearm without any damage to the forearm muscles due to loss of blood supply.

The outcome for pseudo-Volkmann contracture is usually good when it’s recognized and treated early.

Volkmann contracture symptoms

Volkmann contracture involves the shortening of one or more of your forearm muscles. This shortening can cause your fingers and wrist to curl in a “claw-like” position.

Symptoms can be mild, moderate, or severe:

Mild Volkmann contracture

Mild Volkmann contracture is limited to the muscle flexor digitorum profundus. This muscle runs down the front of your forearm and allows you to flex your fingers.

People with mild Volkmann contracture may only have shortening of two or three fingers, often the middle and ring fingers. Usually, there are no or minimal neurological symptoms.

Moderate Volkmann contracture

Moderate Volkmann contracture involves your flexor digitorum profundus and flexor pollicis longus muscles. Flexor pollicis longus allows you to flex your thumb. Other muscles in your forearm that allow you to flex your fingers and wrist may also be involved.

In people with moderate Volkmann contracture, all five fingers and the wrist are often involved. They may also lose sensation in parts of their hand or lower arm.

Severe Volkmann contracture

Severe cases of Volkmann contracture involve both the flexor and extensor muscles. It results in severe distortion of the fingers and hand with significant loss of sensation.

Acute compartment syndrome symptoms

Acute compartment syndrome can cause symptoms that start suddenly, such as:

• severe muscle pain
• swelling or bulging of a muscle
• tightness or difficulty moving a body part

It can occur anywhere in your arms and legs, often after traumatic injuries.

Potential complications of Volkmann contracture

Volkmann contracture can result in a partial or complete loss of function of your hand depending on the severity of muscle damage. Some people also have mild to severe loss of sensation in their hand or forearm.

When to get medical help

Get medical help if you have problems with the function of your hand or wrist, especially if the problems occur after a sudden injury. A doctor can order tests to help find the underlying cause.

Medical emergency

It’s critical to get immediate medical attention if you develop symptoms of acute compartment syndrome, especially if these symptoms develop after a sudden injury.

Go to the nearest emergency room if you have the symptoms listed in this article.

Volkmann contracture diagnosis

Some doctors may make the diagnosis based solely on the results of a clinical exam where they:

• consider your personal and family medical history
• consider your symptoms
• perform a physical exam

You may also receive additional tests, like:

• X-rays
• tests to measure your nerve function
• tests to measure your muscle function

Volkmann contracture treatment

The primary emergency treatment for acute compartment syndrome is fasciotomy. In this procedure, a surgeon cuts the layer of connective tissue around your muscle to relieve pressure.

Once Volkmann contracture has already developed, treatment depends on the severity of your symptoms.

Mild cases may be treated with:

• physical therapy
• splinting
• muscle stretching
• surgery to lengthen your tendons

Moderate contractures may require:

• surgery to lengthen your tendons
• neurolysis, a surgery to release a nerve from scar tissue
• tendon transfer surgery

Severe contractures may need a surgery called radical debridement. In this procedure, a surgeon removes damaged muscle tissue.

Living with Volkmann contracture

Getting immediate treatment can help improve the outlook of people with Volkmann contracture. A prompt fasciotomy within 6 hours can reduce muscle damage caused by acute compartment syndrome.

Nearly all cases of Volkmann contracture that occur during childhood cause a permanently short limb.

People with mild contracture may be able to regain normal function in their wrist and hand. People with more severe cases may not regain full function.

Can you prevent ;Volkmann contracture?

The primary cause of Volkmann contracture is acute compartment syndrome, which is often caused by a sudden injury.

You can take precautions to avoid traumatic injuries by:

• wearing proper sports equipment
• avoiding situations with a high risk of falling
• wearing a seat belt while in a vehicle

Some causes of Volkmann contracture, like tumors, are mostly unavoidable.

What⁢ is Volkmann Contracture?

Volkmann Contracture is a condition that results in‌ the permanent shortening⁤ of forearm muscles, leading‍ to a claw-like deformity of the‌ hand and ⁤fingers. It typically arises‍ due​ to a lack ⁣of blood flow to the forearm muscles.

‌ What are the Symptoms of‍ Volkmann Contracture?

Symptoms of Volkmann Contracture include‌ pain, swelling, and a noticeable deformity in the hand or fingers.⁤ Other signs may include stiffness⁤ and an inability to move⁣ the hand‍ or fingers properly.

What Causes Volkmann⁤ Contracture?

The primary⁣ cause of Volkmann Contracture ⁣is an injury‌ that disrupts blood flow to the forearm muscles. This can ⁤occur due to fractures,‍ especially of the elbow or forearm, ⁤or from tight bandages and casts.

⁢ How is Volkmann Contracture Diagnosed?

Diagnosis​ is primarily based on⁣ physical examination‍ and patient history. Doctors may use imaging tests like X-rays, MRIs, or electromyography to assess muscle and ⁣nerve damage.

⁣What ‌are the⁤ Treatment‌ Options for Volkmann Contracture?

Treatment for Volkmann Contracture focuses on restoring⁣ blood⁤ flow and ⁤function. This may⁤ include physical therapy, splinting, and in severe‌ cases, surgery to remove or ​repair ​damaged tissue. Early intervention is⁤ crucial to prevent permanent damage.

Can Volkmann Contracture be Prevented?

While it‍ might ⁤not always be preventable, quick treatment of forearm ⁤injuries ⁣and‍ care‌ while applying medical casts can reduce the risk. Ensuring proper blood flow and monitoring ⁢for any ⁤signs of complications are ⁣also key​ preventive measures.

Takeaway

Volkmann contracture is when the muscles in your forearm become permanently shortened and cause your fingers and wrist to curl in a “claw-like” position. Acute compartment syndrome most commonly causes it.

The symptoms of Volkmann contracture can range from mild to severe. Treatments like physiotherapy or surgery may help improve the function of your hand and wrist.