f Post graduate mcqs and discussion : volkmann ischemic contractures

Thursday, April 12

volkmann ischemic contractures

Q. Most common muscles involved in volkmann ischemic contractures are .

A. Flexor digitorum profundus
B. Flexor carpii ulnaris
C. Flexor digitorum superficialis
D. Flexor pollicis longus

Ans : Flexor digitorum profundus

Most commonly involved muscles are Flexor digitorum profundus( most common )  and Flexor pollicis longus.

Ischemic injury to the muscle and nerves on the flexor compartment of the forearms.  It is caused due to occlusion of the brachial artery by a supracondylar fractures.  The ischemic muscles are gradually replaced by fibrous tissue which contracts and draws the wrist and finger  into flexion. 

Clinical features :

Marked atrophy of forearm muscles
Flexion deformity of the wrists and fingers
Skin over the forehand and hand is dry and scally
Nail shows atrophy changes .

Treatment :

Mild deformities can be corrected by passive stretching of the contracted muscles using a turn buckle splint .

For moderate deformity a soft tissue sliding operations where the flexor muscles are released fromTheir origin at the medial epicondyles and ulna is performed ( max page operations ) .

For sever deformities bone opreation such as shortening of forearms bones , carpal bone excision etc. May be required.