Revista de fisioterapia y rehabilitación física

A Case Report of a Juvenile Volkmann’s Ischemic Contracture

Abstract

Aiyejusunle CB, Oluwafunmi L and Kehinde AA

Aim: This study was conducted to determine the outcome of physiotherapy intervention in a juvenile case of Volkmann’s ischemic contracture.
Methodology: The patient was an 8-year-old female pupil presenting with flexion deformity of the right elbow, wrist and fingers accompanied with pain and difficulty in performing activities of daily living of 5 months onset. She received physiotherapy including home program for 43 sessions with a periodic review of the intervention after the 22nd, 33rd and 43rd treatment sessions.
Results: The outcome variables included pain intensity, range of motion, muscle girth, and functional ability. Ranges of motion changed as follows: elbow flexion 85° to 120°; elbow extension 85° to 120°;  wrist flexion 18° to 19°; wrist extension 36° to 46°; pronation 30° to 180°; supination 50° to 180°. The patient demonstrated palpable improvements in all these parameters. Pain also dropped from 7 to 4 and sometimes lesser. There was no significant muscular atrophy in the forearm despite the compromise of the muscle length-tension relationship but in the thenar and hypothenar eminences. A very tiny, subtle and rather tricky to detect anesthetic spot was observed on the palm.
Conclusion: We therefore concluded that physiotherapy had a positive outcome for children with Volkmann’s  ischemic contracture and had the potential to reduce the cost of future surgeries for patients.