VOLKMANN’S ISCHEMIC CONTRACTURE;

Objective: To share our experience of post-circumferential Volkmann’s IschemicContracture (VIC) of the forearm seen in our setup. Design: A descriptive case series study.Setting: National Orthopedic Hospital, Bahawalpur, Pakistan. Period: January 2005 toDecember 2013. Methodology: A total of 42 patients were registered during the study period.Patients with VIC of the forearm resulting from direct circumferential compression were includedin the study. Patients who developed VIC of forearm indirectly secondary to arm pathology orother causes were excluded from the study. Assessment was made by detailed history, clinicalexamination and radiographs of the involved extremity. The age, sex, duration, side and type ofcontracture, length and width of forearm and resulting deformities were all documented on adetailed proforma. Patients were categorized into three types accordingly. Results: Forty twopatients comprising 29 males and 13 females were seen. Their ages ranged from 1 to 53 yearswith mean age of 14.47 years. Duration of established VIC of the forearm after insult ranged from 3months to 6 years with mean duration of 2 ½ years. Most frequent type of contracture wasmoderate variety seen in 19 patients (45.23%) with 14 cases on the right and 5 cases on left sidefollowed by severe varieties which were present in 13 patients (31%) with 10 cases on the rightand 3 cases on left side. Mild contractures were found in 10 patients (23.9%) with 6 cases on theright and 4 cases on left side. In 26 of 42 patients, a difference in forearm length that ranged from79% to 94% (mean, 80%) was observed. Majority of cases (37 cases) of VIC occurred after TBS forradius and ulna fractures while in the remaining 5 cases, contractures of forearm occurred due totight plaster of paris (POP) splint. Conclusions: Post-circumferential forearm contractures afterTraditional Bone Setters (TBS) are common in our society. Community awareness through healtheducation and conducting medical camps and seminars might play a role in decreasing theinfluence of TBS.