Anatomy · Upper Limb

Compartment syndrome of arm/forearm

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  • Volkmann's ischaemic contracture (ischaemic compartment syndrome): permanent flexor deformity of the forearm and hand following ischaemic necrosis of the forearm flexor muscles.

Aetiology and Pathogenesis

  • Caused by sudden complete occlusion of the brachial artery (e.g. tight plaster cast) or its laceration in supracondylar fracture of the humerus.
  • Occlusion causes ischaemia of the forearm flexor muscles, causing their paralysis within a few hours.
  • Forearm flexor muscles tolerate ischaemia for only 6 hours; beyond this they undergo necrosis.
  • Necrotic muscle is then replaced by fibrous tissue, which shortens permanently.