Volkmann's ischaemic contracture and its relationship to fracture of the femur.

Volkmann’s ischaemia is still an uncommon condition. During a fifteen-year period in Platt’s fracture clinic only eight cases were recognised in 21,000 fractures. All were in the upper extremity. To quote from Parkes (1945): “The condition occurs most frequently in the flexor muscles of the forearm, usually following supracondylar fracture of the humerus. It is perhaps unfortunate that attention has been so focused on this region that it is probable the condition has frequently passed unrecognised in other muscle groups. Yet there is no reason why, given the necessary etiological conditions, it should not be found elsewhere and, in fact, a number of cases have been described.” In spite of this statement, however, he cites fifteen cases of “ traumatic ischaemia of peripheral nerves “ and of the nine cases in the lower extremity he only admits that one could possibly be due to Volkmann’s ischaemia. We have been struck in our clinic with the menacing occurrence of Volkmann’s ischaemia in the lower extremity and with the almost complete lack of reported examples from other centres. It is for that reason that this report, which covers the seventeen years from 1931 to 1947, is presented. During this period forty-two cases of ischaemia were observed (Table I).