
volkmann's ischaemia
volkmann's ischaemia is the name given to a sequence
of events originally described by volkmann in 1881.
basically the condition consists of the replacement of
the limb flexor muscles by fibrous tissue following injury or
occlusion of the main arterial supply of blood to these
muscles.  the condition is rare fortunately--mainly because
of improved methods of prevention.  the flexor muscles of
the toes are sometimes affected, but the commonest group of
muscles so damaged are the flexor muscles of the forearm.
total arterial occlusion to a limb for several hours usually
causes frank gangrene; partial or total occlusion for shorter
periods may give rise to ischaemic contracture.  the muscles,
being deprived of their blood supply, die and are sub-
sequently replaced by fibrous tissue.  like all scars, the fibrous
tissue contracts, producing the complete picture of
volkmann's ischaemic contracture.  the forearm is thin and
wasted, and the fingers are held in flexion owing to the
overall shortening of the flexor muscles.  in severe cases, if
the nerves are also affected or if the entire muscle mass is
replaced by fibrosis, the fingers may be totally paralysed
as well.
