Volkmann’s ischemic contracture

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Ischemic contracture

If there is a forearm or elbow fracture, you should use a sling or splint to keep the area still and raise the arm above heart level. This helps prevent further injury and excessive swelling.

The best treatment is early surgery to release the pressure in the forearm before any permanent injury to the muscles and nerves occurs. Reconstructive surgery to lengthen and sometimes transfer muscles is necessary to try to regain some hand function.

How well a person does depends on the severity and stage of disease at the time treatment is started.

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If surgery to relieve pressure is performed before permanent damage occurs, then the outcome is usually excellent. The wounds are usually left open (covered with a sterile dressing) and closed later (usually 48 - 72 hrs later) during a second surgery, once the swelling has resolved. Sometimes, several surgeries are needed to close the wound safely.

If there is high pressure in the forearm for an extended period of time, the muscles and nerves can be permanently damaged. If a nerve is compressed for longer than 12 to 24 hours, it will usually become permanently damaged.

People with mild muscle contractures involving only a few fingers have a better chance of returning to normal function. People who lose normal function of all the muscles that move the fingers and wrist need major reconstructive surgery and do not have a complete recovery.

The more severe the contracture, the worse the function of the hand and wrist. In severe cases, the hand may not work at all, and you may have a loss of sensation (feeling) in the area.

Contact your health care provider for an appointment if you have had an injury to your elbow or forearm and have developed swelling.

Review Date: 07/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).