Untypical case of Volkmann ischemic contracture

Abstract

Introduction

Volkmann contracture, is the result of complications of limb injuries usually the upper limbs, which leads to necrotic changes in the muscles. The first symptom of Volkmann contracture of the upper limb is an acute burning pain, blue fingers, restriction of the movement and lack of pulse in the radial artery. In the early stage the patient experiences disorders of feeling in the form of numbness and tingling. Volkmann contracture is characterized by 4P- pallor, pain, pulsenees, paralysis. We see typical positioning of the arm in the bend of the wrist, extension of the fingers in the metacarpophalangeal joints and a bend in the interphalangeal joints.

A 34 year-old patient came to the Surgical Clinic with a pain in the right forearm. She experienced a slight painfulness in one half of her right forearm, where a small blivter filled with serum was observed. The patient was admitted to the Surgical Ward where antibiotic therapy was administered. On the second day of her stay in hospital the woman had a fever of 40º C and the characteristic positioning of the arm occurred. In general anesthesion a cut was made in the fascia on the palm side of the fore- 71 arm. A big abscess of the deep flexor compartment was removed and on the following day physiotherapy was included in the treatment.

Conclusions

The reason for occurrence of Volkmann ischemic contracture was an abscess in deep flexor compartment within the forearm. Surgical treatment that consisted in opening the abscess and making wide cuts in the fascia, as well as rapid physiotherapy prevented lasting changes and resulted in complete healing of the patient.