Volksman contracture Flashcards
what is volksman contracture?
A Volkmann’s contracture is deformity of the hand, fingers, and wrist which occurs as a result of a trauma such as fractures, crush injuries, burns and arterial injuries. Following this trauma, there is a deficit in the arterio-venous circulation in the forearm which causes a decreased blood flow and hypoxia can lead to the damage of muscles, nerves and vascular endothelium. This results in a shortening (contracture) of the muscles in the forearm.[1][2]
Characteristics/Clinical Presentation
Special findings:
Bleach view at the level of the skin (pallor).
The wrist is in palmar flexion
Clawed fingers
Pain occurs with passive stretching of the flexor
Palpation of the affected region creates persistent pain (pain)
It is possible that the pulsations can not be felt in the swollen arm, mainly in the distal part (pulselessness).
There are also neurological limitations noticeable from the muscles that pinch the neural pathways, there is a decreased sensation (paresthesia) and there is an observable motor deficit (paresis).[6]
Physiotherapy Management
After the surgery, it is important to ensure that the mobility is recovered by:
Passive stretching techniques
Range of motion exercises to enhance soft tissue elasticity.
Another part of the therapy programme involves activating and strengthening the weak agonist to ensure equilibrium in agonist and antagonist pull during joint movement.
Progressive Splinting, passive stretching and tendon gliding, as well as massage can be used in mild to moderate cases of Volkmann’s contracture.
By the use of an electromyographic device, the patient can train its affected muscles with cooperativity. The patient is more alert and there is more interaction between the patient and the therapist.
The majority of Volkmann’s contractures are caused by!
supracondylar fracture,
