Case Studies – Pollicisation

Volkmann contracture (or Volkmann ischemic contracture) is a permanent shortening (contracture) of forearm muscles, usually resulting from injury, that gives rise to a claw-like deformity of the hand, fingers, and wrist.

It can be caused due to neglected trauma or tight plaster leading to increase compartment pressure eventually leading to muscle necrosis

It is more common in children.

18 year old boy had a childhood fracture which was treated with cast. However, due to tight cast and compartment syndrome muscle necrosis happened. This lead to nerve injury and muscle shortening

In Moderate VIC

• Release of FDS and FDP

• Z plasty of FCR

• FDS transfer to FDP

• FCU transfer to ECRB

• Neurolisis of median and ulnar nerve

• Patient has a functional hand

• He is able to do activities of daily living

• Cosmetically also hand looks good

• Sensations recovered as nerves are freed.