The relief of traumatic arterial spasm in threatened Volkmann's ischaemic contracture.

The etiology of Volkmann’s contracture has been much debated. Incorrect bandaging (Volkmann 1881), venous occlusion (Murphy 1914, Brooks 1922, Jepson 1926), subfascial haematoma (Moulonguet and Sen#{232}que 1928, Jos#{233} Jorge 1925), arterial spasm (Griffiths 1940) are some of the causes that have been suggested. Leriche (1928) likened the changes in the muscles to those seen in cardiac and pulmonary infarction. In the forearm, muscle necrosis may affect the extensors as well as the flexors; this distribution can be explained by attributing the necrosis to arterial occlusion (Seddon 1956). Massart (1935) observed that the muscles were infiltrated by a sero-haemorrhagic exudate and that they appeared ready to burst. Personal observations at operation on patients suffering from limb injuries with vascular complications suggest that the presence of oedema alone in a neighbouring fascial compartment may be an important etiological factor.