Volkmann's contracture in children: aetiology and prevention

J Bone Joint Surg Br. 1979 Aug;61-B(3):285-93. doi: 10.1302/0301-620X.61B3.479251.

Abstract

A review was conducted of the records of fifty-five children who were admitted to the Hospital for Sick Children in Toronto between 1955 and 1975 with a diagnosis of Volkmann's contracture in fifty-eight limbs. Ten patients had been transferred to this hospital with established ischaemia after Bryant's traction for a fractured femur; all had a very poor outcome. Thirteen other cases of Volkmann's contracture affecting the superficial posterior compartment had been treated with a fixed Thomas' splint and a Bradford frame after fractures of the femoral shaft. Supracondylar fractures of the elbow resulting in Volkmann's contracture frequently had both an arterial injury and a compartment syndrome. Most of the fifty-five children reviewed here had not had early appropriate treatment. For the past twenty-one years the frequency of Volkmann's contracture has not declined in spite of many published reports on the compartment syndrome, and the hazards of supracondylar fractures and of Bryant's traction.

MeSH terms

  • Adolescent
  • Arm Injuries / complications*
  • Arm Injuries / therapy
  • Arteries / injuries
  • Child
  • Child, Preschool
  • Compartment Syndromes / etiology*
  • Compartment Syndromes / prevention & control
  • Compartment Syndromes / therapy
  • Female
  • Femoral Fractures / complications
  • Femoral Fractures / therapy
  • Forearm Injuries / complications
  • Forearm Injuries / therapy
  • Fractures, Bone / complications*
  • Fractures, Bone / therapy
  • Humans
  • Humeral Fractures / complications
  • Humeral Fractures / therapy
  • Ischemia / complications*
  • Ischemia / etiology
  • Ischemia / therapy
  • Leg Injuries / complications*
  • Leg Injuries / therapy
  • Male
  • Tibial Fractures / complications
  • Tibial Fractures / therapy
  • Time Factors