Volume 9, Issue 2 (4-2020)                   wjps 2020, 9(2): 166-173 | Back to browse issues page

DOI: 10.29252/wjps.9.2.166


XML Print


Assistant Professor and Chairman, Department of Plastic surgery and Burns, National Institute of Rehabilitation Medicine (NIRM), Street No.9, G-8/2, Islamabad 44000, Pakistan. Phone No. +923355411583
Abstract:   (570 Views)
BACKGROUND
Established Volkmann’s ischemic contractures (VICs) represent the eventuality of neglected acute compartment syndrome (ACS) of the forearm. This study assessed the clinical and demographic presentation of VICs. 
METHODS
This study was conducted at Department of Plastic Surgery, National Institute of Rehabilitation Medicine, Islamabad, Pakistan over a period of three years and included all patients of either gender who presented with VICs and analyzed various corrective procedures instituted as surgical remedies.
RESULTS
Among 37 included patients, 83.78% were male and 16.21% were female (mean age: 16.51±9.1 years). The underlying causes of the initial traumatic insults were tight bandages employed by traditional bone setters for treating forearm fractures (83.78%), high voltage electric burns involving hands/forearms (13.51%) and supracondylar fracture with vascular compromise (2.70%). Majority of patients belonged to Holden type 2 (97.29%) and Tsuge type 2 VICs (48.68%). The most common sufferers of VICs were young, illiterate males coming from rural regions. Treatment for forearm fractures by traditional bonesetters constituted the most common underlying cause. Most of the patients were managed with combination of procedures including tendon transfers, excision of the fibrosed muscles, tenolysis and neurolysis of median and ulnar nerves. Tendon transfers were the commonest corrective procedures instituted.
CONCLUSION
This study highlighted the gravity of this largely preventable but neglected catastrophe and there is a need to institute robust preventive measures to address the issue. Emphasis should be on creation of public awareness and robust education of health care providers to ensure correct primary management of upper limb trauma.
Full-Text [PDF 2469 kb]   (199 Downloads)    
Type of Study: Original Article | Subject: Special
Received: 2020/01/22 | Accepted: 2020/04/13 | Published: 2020/04/13