Volkmann syndrome: Definition, Causes, Symptoms, Treatment

Volkmann syndrome is a complication of another disease, compartment syndrome. Volkmann syndrome is a pathology with several symptoms that affect the forearms and hands.


Compartment syndrome, or compartment syndrome, is caused by increased pressure in the muscle compartments found in the legs, forearms, and hands, which are called compartments. This excessive pressure generally follows post-traumatic edema. It may be accompanied by ischemia, which is characterized by poor blood circulation. When compartment syndrome, especially in the forearms, is not treated and sets in, Volkmann syndrome appears. What is Burnout Syndrome? How to Recover?

1. Definition of Volkmann Syndrome

Compartment syndrome, which is characterized by increased tissue pressure in one or more muscle compartments, occurs during exercise or following trauma. It is a pathology whose symptoms mainly appear during exercise, with pain, a feeling of numbness, or even swelling. According to the medical journal The MSD Manual, compartment syndrome is rare but serious. When it is not quickly taken care of or the treatment is not adapted, the Volkmann syndrome can then appear. Volkmann syndrome is therefore usually a direct consequence of compartment syndrome. It appears, most of the time, two months after the installation of compartment syndrome, if it has not been treated properly. What is Ramsay Hunt syndrome? The disease that Justin Bieber suffers

Historically, Volkmann’s syndrome more particularly affects the forearms. It is a sequela linked to ischemia of certain muscles of the forearm, that is to say, a lack of blood supply and oxygen in this area. Today, it is accepted that Volkmann syndrome can also affect other areas of the body that may be affected by compartment syndrome, such as the legs. In its most severe form, Volkmann syndrome can cause cell death and muscle retraction in the affected area.

2. Symptoms of Volkmann Syndrome

Volkmann syndrome is defined by a chronic onset of compartment syndrome. The muscles of the affected area will transform. This muscle fibrosis is characterized by red and elastic muscles that become very hard and very retracted tissue.

At first, the patient will experience symptoms related to compartment disease, such as:

  • Strong diffuse pain, greater than that which can be felt during a trauma;
  • Pain when moving your fingers or toes;
  • Loss of sensation in the area or tingling;
  • An inability to move the hand or foot of the affected limb;
  • Stiffness of the limb concerned;
  • Limited efficacy of analgesics.

If compartment syndrome is not treated quickly, whether by reducing effort, through drug treatment, or even with surgery, it can turn into Volkmann syndrome. New symptoms may then appear:

  • Pain described as intolerable;
  • Loss of feeling in the extremities;
  • Flexions, at the level of the wrist and the phalanges, for example, become permanent.

When Volkmann syndrome affects the forearm, it is therefore often characterized by a claw-like hand, because the flexor muscles have retracted.

3. Causes of Volkmann Syndrome

Volkmann syndrome is usually a sequela of compartment syndrome. Compartment syndrome will indeed cause excessive pressure on muscle tissue, which will hinder blood circulation. This will lead to a decrease in oxygenation of the muscles. These can no longer function properly. This is when Volkmann syndrome appears. The activity of the muscles will then be reduced, then gradually become non-existent. If it goes on too long, they will retract and their cells will die. The Healing Crystals and Stones for Muscle Tension

Volkmann syndrome can be caused by several causes:

  • Trauma-related to muscle injury
  • Fracture-related trauma
  • Dislocation-related trauma
  • Placing a cast, bandage, or tourniquet that is too tight which will interrupt blood circulation ;
  • A hematoma that will fill the tissues with blood and become compressive;
  • An edema

4. Volkmann syndrome: when to consult?

It is essential to consult a doctor immediately as soon as you feel the first symptoms related to compartment syndrome and/or Volkmann syndrome. The French Institute of Hand Surgery (IFCM) also specifies that the results of the treatment of acute compartment syndrome are quite mediocre mainly due to the frequent delay in diagnosis, and indicates that there are “70% of good results for treatment before the 12th hour, compared to less than 10% after this period and less than 30% of patients without sequelae”.

You should also know that too late treatment can lead to the loss of the limb concerned. An amputation is indeed necessary if the tissues die because the blood supply has been interrupted for too long. If the patient has recently had a trauma to the limb and/or has a splint or a cast, consult as soon as possible if increasing pain appears in the immobilized limb, pain appears in the extremities, or numbness is felt in the affected limb. Best Healing Crystals and Stones for Muscle Injuries And Weakness

5. Examinations and diagnosis of Volkmann syndrome

The diagnosis of Volkmann syndrome is based on a clinical examination. An interrogation is first carried out, to better understand the symptoms felt by the patient, but also to find out about the possible cause of the syndrome. The diagnosis can be confirmed by measuring the pulse at the site concerned. To confirm the diagnosis, a measurement of intramuscular pressure may be prescribed. This involves placing a device on the patient with a needle that will be implanted in the muscle compartment. Three measurements are then taken: at rest, one minute after exercise, and five minutes after exercise.

Other tests may also be ordered to allow healthcare professionals to rule out other possibilities, such as:

  • A blood test
  • An MRI
  • An echo-doppler
  • Scintigraphy
  • A radiograph
  • An electromyogram to measure neuromuscular activity

6. Treatments for Volkmann Syndrome

When compartment syndrome and/or Volkmann’s syndrome appear following the placement of a cast, health professionals recommend the removal of the cast as a matter of urgency or even a discharge aponeurotomy in the most serious cases. This surgery involves removing the diseased tissue, which is called the strings. For this, the surgeon will make several incisions along the muscle compartment. This will allow him to eliminate excessive compression in the muscle compartments, and also to have access to the tissues to be removed. Following this operation, it is sometimes necessary to perform a skin graft.

Aponeurotomy is also recommended if Volkmann syndrome has other causes. At the same time, other treatments can be considered to limit the damage, such as intramuscular lengthening of muscles that are still alive and slightly retracted.

7. How to prevent Volkmann syndrome?

To properly prevent Volkmann syndrome, you must first prevent compartment syndrome. For this, there are several ways. First of all, you should know that sports that use the same muscles repeatedly and excessively promote compartment syndrome. When practicing running, cross-country skiing, skating, swimming, or even windsurfing, it is, therefore, necessary to be very attentive. If symptoms related to compartment syndrome appear, it is important to follow the most appropriate treatment so that Volkmann syndrome does not appear later. This can go through a reduction in physical effort, medical treatment with vagotonic drugs, wearing compression socks, or even physiotherapy sessions.

Since Volkmann’s syndrome is caused by an interruption of blood circulation, it is then necessary to avoid putting bandages or casts that are too tight. The medical teams are making sure to strengthen the monitoring of patients at risk, in order to react as quickly as possible if symptoms appear. It should be noted that children may be more particularly affected by Volkmann syndrome. It is indeed a pathology that can occur following a fracture in the forearm, and children are more often subject to this type of trauma.

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