Topic
Volkmann's Ischemic Contracture
About: Volkmann's Ischemic Contracture is a research topic. Over the lifetime, 51 publications have been published within this topic receiving 1089 citations.
Papers published on a yearly basis
Papers
TL;DR: Forearm compartment syndrome in the newborn is not as uncommon as previously thought and early diagnosis and appropriate referral led to the salvage of a functional limb in 1 of the patients in this series.
Abstract: Purpose Isolated cases of ischemia, compartment syndrome, or Volkmann's ischemic contracture in the forearm of the newborn infant have been reported in the past. The purpose of this study is to review a large series of patients with neonatal forearm compartment syndrome and to report the important clinical features. Methods A search of medical records from 1980 to 2000 identified 24 children with evidence of ischemia of the forearm at the time of birth. Records and images were reviewed for prenatal and birth history, maternal factors, medical conditions, pattern of involvement, treatment, and outcomes. Patients were grouped according to the extent of initial soft-tissue involvement. Results All patients presented with a sentinel forearm skin lesion. Patterns of involvement ranged from mild skin and subcutaneous lesions to dorsal and volar compartment syndrome with or without distal tissue loss. Early treatment intervention was limited to a single case in which the diagnosis of compartment syndrome was made and an emergency fasciotomy was performed with a good outcome. In other cases tissue loss, compressive neuropathy, muscle loss, and late skeletal changes were responsible for impaired function. Distal bone growth abnormality was common. Conclusions Forearm compartment syndrome in the newborn is not as uncommon as previously thought. The skin lesion was the common, salient, initial diagnostic finding. Early diagnosis and appropriate referral led to the salvage of a functional limb in 1 of the patients in this series. The severity of the initial insult correlated with the degree of impairment in growth and function. The delayed diagnosis and treatment of an evolving compartment syndrome may compromise further final function.
107 citations
TL;DR: The diagnosis of ischaemia in an injured limb and the indications to operate on it can usually be made on clinical grounds alone.
Abstract: Ischaemia is a rare complication of injury to a limb but must be excluded in every case. Two distinct types occur: Type I, where a proximal arterial injury gives rise to ischaemia distally; and Type II, where a direct injury gives rise to ischaemia at the site of the injury. Whatever the nature of the insult, an ischaemic contracture only develops as a result of swelling of the soft tissues where these soft tissues are contained in un unyielding osteofascial compartment. This secondary ischaemia can only be relieved by a timely fasciotomy. The diagnosis of ischaemia in an injured limb and the indications to operate on it can usually be made on clinical grounds alone.
105 citations
TL;DR: Immediate reduction and fixation followed by careful evaluation and treatment of ischemia were associated with excellent outcome in four of the five children with significant vascular injuries with absent or diminished radial pulses on presentation.
Abstract: Between 1988 and 1994, 128 consecutive children with grade III supracondylar humeral fractures presented for treatment at our hospital. Seventeen had absent or diminished (detected with Doppler but not palpable) radial pulses on initial examination. Fourteen of these 17 children recovered pulse (palpable) after reduction and stabilization of their fractures. The remaining three had persistent absence of radial pulse. Each of these three children was explored immediately and found to have a significant vascular injury requiring repair. Two of the 14 children who had initially regained their pulses had a progressive postoperative deterioration in their circulatory status during the first 24-36 h, including loss of the radial pulse. Both of these children had arteriograms that identified vascular injuries. Both underwent exploration and bypass grafting. One of these two children had been transferred 48 h after injury, resulting in delay of management of his vascular impairment. Despite exploration, vascular repair, and fasciotomy, he ultimately developed Volkmann's ischemic contracture. All five children with significant vascular injuries had absent or diminished radial pulses on presentation. Immediate reduction and fixation followed by careful evaluation and treatment of ischemia were associated with excellent outcome in four of the five children.
103 citations
TL;DR: The disease first described by Volkmann in 1881 is generally considered to result from spasm of the main arteries of the forearm and their branches as a consequence of trauma to the elbow or forearm.
Abstract: VOL. 57-A, NO. 7, OCTOBER 1975 925 The disease first described by Volkmann in 1881 is generally considered to result from spasm of the main arteries of the forearm and their branches as a consequence of trauma to the elbow or forearm. The severe and prolonged but incomplete interruption of arterial blood supply, together with venostasis, produces acute ischemic necrosis of the flexor muscles. The most marked ischemia occurs in the deeply situated muscles such as the flexor pollicis bongus and flexor digitorum profundus, but severe ischemia is evident in the pronator teres and flexor
100 citations
96 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 2 |
| 2020 | 2 |
| 2019 | 1 |
| 2017 | 1 |
| 2016 | 1 |
| 2015 | 2 |