DOI QR코드

DOI QR Code

Severe Flexor Digitorum Profundus Muscular Adhesion by Pseudo-Volkmann's Contracture without Fracture: A Case Report and Literature Review

  • Jae Woo Kim (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ;
  • Jong Chan Kim (Department of Plastic and Reconstructive Surgery, National Police Hospital) ;
  • Sung Hoon Koh (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ;
  • Jin Soo Kim (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ;
  • Si Young Roh (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ;
  • Kyung Jin Lee (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ;
  • Dong Chul Lee (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital)
  • Received : 2024.04.09
  • Accepted : 2024.08.17
  • Published : 2024.11.15

Abstract

Volkmann's ischemic contracture is a condition characterized by permanent ischemic damage to muscles and nerves due to vascular insufficiency, resulting in flexion contractures of the affected limb. In contrast, pseudo-Volkmann's contracture presents with similar clinical features but lacks ischemic damage and has the potential for complete recovery. We report a case of a 39-year-old man who developed failure of extension in the middle and ring fingers of the left hand following blunt forearm trauma from a rolling machine. Despite no skin breakage or fracture, his symptoms progressively worsened over 2 months without treatment. Surgical exploration 2 years later revealed severe adhesions of the flexor digitorum profundus muscle at the myotendinous junction to the ulnar periosteum, with immediate recovery after release. This case highlights pseudo-Volkmann's contracture in an adult without fracture, likely due to blunt trauma causing delayed adhesion formation.

Keywords

References

  1. Meyerding HW, Krusen FH. The treatment of Volkmann's ischemic contracture. Ann Surg 1939;110(03):417-426 
  2. Tsuge K. Treatment of established Volkmann's contracture. J Bone Joint Surg Am 1975;57(07):925-929 
  3. Aggarwal N, Singh B, Gureja Y. Compression ischaemia of limbs from tight splintage. J Bone Joint Surg Br 1969;51:779-780 
  4. Eaton RG, Green WT. Volkmann's ischemia. A volar compartment syndrome of the forearm. Clin Orthop Relat Res 1975;(113):58-64 
  5. Botte MJ, Keenan MAE, Gelberman RH. Volkmann's ischemic contracture of the upper extremity. Hand Clin 1998;14(03):483-497, x 
  6. Littlefield WG, Hastings H II, Strickland JW. Adhesions between muscle and bone after forearm fracture mimicking mild Volkmann's ischemic contracture. J Hand Surg Am 1992;17(04):691-693 
  7. Ultee J, Hovius SE. Functional results after treatment of Volkmann's ischemic contracture: a long-term followup study. Clin Orthop Relat Res 2005;(431):42-49 
  8. Holden CE. The pathology and prevention of Volkmann's ischaemic contracture. J Bone Joint Surg Br 1979;61-B(03):296-300 
  9. Jeffery CC. Contracture of fingers due to fixation of the flexor profundus digitorum to the ulna. Hand 1976;8(01):32-35 
  10. Baudet J, Lafond P. Pseudo-Volkmann Syndromes. 1979:173-181 
  11. Koluacik S, Yilmaz O, Aslanturk O. Treatment of a neglected flexor digitorum profundus entrapment after closed reduction of both bone forearm fracture: a case report. Jt Dis Relat Surg 2021;32(03):810-813 
  12. Akita S, Kawai H. Entrapment of the flexor digitorum superficials in the radius fracture site. J Hand Surg Am 2005;30(02):308-311 
  13. Geissler J, Westberg J, Stevanovic M. Pseudo-Volkmann contracture: a case report and review of the current literature. J Am Acad Orthop Surg Glob Res Rev 2018;2(11):e031 
  14. Hendel D. Prevention of chronic entrapment of the ring finger flexor profundus muscle in ulnar shaft fractures in children-a case report. Acta Orthop Scand 2004;75(04):503-504 
  15. Deeney VF, Kaye JJ, Geary SP, Cole WG. Pseudo-Volkmann's contracture due to tethering of flexor digitorum profundus to fractures of the ulna in children. J Pediatr Orthop 1998;18(04):437-440