Volkmann syndrome

Volkmann syndrome's disease overview

Volkmann syndrome is a shrinkage of limbs, the most common is fingers and wrists causing claw deformation due to anemia nourished. The passive stretching of the fingers is limited and painful. The disease is named after the German doctor Richard von Volkmann (1830-1889) was the first to describe the Volkmann syndrome. Initially, he thought that neurological damage was the cause of the disease because the muscle contraction occurred simultaneously with the symptoms of paralysis.

After injuries such as fractures, crushing software, burns, blood vessels, circulation to the hands is often limited, does not provide enough oxygen to nourish muscles, nerves and cells Blood vessels, leading to shrinkage, hand deformation.

Volkmann syndrome is a disorder that is not too common, the incidence of only about 0.5% of the population. This disorder usually occurs in children, the majority is aged 5 to 8 years old. Volkmann syndrome can also occur in the leg.

Causes of Volkmann syndrome's disease

The cause of Volkmann syndrome is anemia that nourishes deep areas in the tendon cavity of the limb. This is a closed compartment, has the ability to expand poorly and quite cramped. Any damage that increases the pressure inside the compartment can lead to acute compression syndrome.

Bloody flow due to injury or blood vessel malformations flowing inside, increasing the volume of organizations in the compartment but the tendon cavity cannot expand. As a result, the pressure of the compartment increases; Causes anemia to nourish the limb area. Other causes of Volkmann syndrome with the same mechanism may be:

  • hypertrophy
  • The proliferation process

    • Venous thrombosis

  • Burns
  • Low blood albumin

    • epilepsy

    Surgery

    In addition, the cause of the disease may be due to the reduced volume and pressure by external impacts such as braces or bundles of powder too tight. P>

    Symptoms of Volkmann syndrome's disease

    Deformation can appear in any position of the above limb, related to the elbow folding muscles, the muscles of the root. Fold the wrist, folding and thumb, stretched the fingers and folds the finger. Volkmann syndrome can be classified in severity based on clinical symptoms such as:

  • Mild level: There are 2 or 3 deformed fingers, normal feeling or slight decrease
  • Average level: shrink all fingers, thumb towards the palm of the hand. Patients often lose sensation

    • Severe level: All muscles and stretching in the forearm are affected.

    Clinical manifestations of Volkmann syndrome often come with the manifestation of compartment compression syndrome with 5 characteristics:

  • Pain: When examining, the doctor performs the stretching of the fingers will cause the patient to feel the pain increases. 
    • pale: Chi is affected often with pale white, pale.
  • Unable to catch the pulse: the doctor does not feel the pulse when the forearm.

    • Perfect: Patients may have an ant, numbness or loss, reduced sensation

  • Paralysis: The damage may lose function.

    • Pain is the earliest and most reliable symptom. Infinite and paralysis are signs later, heavier prognosis.

    Transmission route of Volkmann syndrome's diseaseVolkmann syndrome

    Volkmann syndrome is not spread from patients to healthy people when interacting with each other. This is not an infectious disease.

    People at risk for Volkmann syndrome's disease

    People with limb lesions increase the likelihood of Volkmann syndrome as follows:

  • Fracture: Especially bone group in the forearm and lower leg area. These are 2 locations that are prone to compression of the cavity syndrome. Fracture on the convex bone of the arm is quite common.
  • Software damage
  • Disorders of coagulation
  • congenital blood vessel deformities.
  • Burns

    • Excessive exercise

    Surgery

  • Injecting drugs improperly indicated

    • Prevention of Volkmann syndrome's disease

    Volkmann syndrome prevention measures need to achieve the goal of ensuring circulation circulation after damage and reducing pressure in the muscle tendon cavity. Some measures are thought to be effective such as:

  • Practicing exercise after surgery
  • Apply passive stretching exercises corresponding to the lesions
  • Strengthen muscle strength, especially the opposites
  • Need to cut vertically when the bundle of powder in the forearm area, the leg

    • Take early diagnosis measures to compression cavity syndrome for timely treatment.

    Diagnostic measures for Volkmann syndrome's disease

    In addition to clinical examination, to accurately diagnose a case of Volkmann syndrome, it is necessary to coordinate the following subclinical media:

  • Measuring the compartment pressure: The doctor can proceed to measure the pressure inside the chamber of the damaged limb to determine the compression syndrome in many ways such as pressure needle, soft tube , ...

    • Vascular ultrasound: Determine the level of perfusion more accurately, help distinguish it from other pathology and find causes related to the circulatory system.

    Volkmann syndrome's disease treatments

    Next need to initially treat Volkmann syndrome to comply with the following principles:

  • Remove tight braces or bundle powder
  • Pain treatment is essential in chronic cases.
    • Conservation of Volkmann syndrome

    Physical therapy and occupational therapy are essential methods to improve the movement of joints, helping patients to recover soon function. 

    Volkmann syndrome surgery

    to prevent the development of Volkmann syndrome, extracted with skin incision, and is a problem that needs to be given priority, especially in high risk cases. Skin incision and weight are usually conducted when the pressure inside the compartment is greater than 30 mmHg.

    When shrinkage has occurred, the choice of specific treatments depends on the severity of the Volkmann syndrome:

  • Mild level: It is necessary to combine the use of dynamic splints, physical therapy and prolonged surgery to improve function.
  • Average level: Neurological resolution surgery, stretched veins can be performed.
  • Severe levels: need deeper and more specific intervention. Scarring tissue should be removed to repair deformities.

    • Surgery often has good results. Patients can restore anatomical and functional characteristics to return to normal life.

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