VOLKMANN'S CONTRACTURE AS A COMPLICATION OF SUPRACONDYLAR FRACTURE OF HUMERUS IN CHILDREN

Abstract

The patient TK, 7 years old, had sustained a supracondylar fracture of  the left elbow after fall on the left hand with elbow extended. She was admitted in local hospital where the clinical examination and X ray were made and they confirmed the diagnosis of supracondylar fracture of the left elbow (Gartland Type III). She was treated with closed reduction (without anaesthesia) and cast immobilization for four weeks. With poor to no function of the left hand she was send to physical therapy for duration of 10 days, but she did not gain her function of the left hand, almost all active movements of the left hand were impossible and the muscles of the left under arm were hypothonic. Due to loss of left hand function,EMG was made and the EMG result showed acute lesion of the nerves of the left forearm caused by possible nerve compression (n.ulnaris, n.medianus, n. radialis). After four months she was admitted in our Clinic were we perform operation of the left elbow with removing callus formation in which we find entrapped median and ulnar nerves. We also did an osteotomy of the humerus for correction of the angular deformity and fixation with K wire. The patient was put in cast immobilisation after surgery for four weeks. After the removal of the cast and K wire she was sent to intensive rehabilitation. One year after surgery she regain almost all of hand and elbow function with satisfying range of motion. She is now able to fullfil every day function without any help or support.