Which statement best describes Volkman's ischemic contracture?

• A. It is a motor deficit due to nerve entrapment
• B. It is a contracture due to ischemia causing muscle necrosis after compartment syndrome
• C. It is a vascular problem
• D. It is a result of a bone fracture

Answer: (B)

Volkman's ischemic contracture happens when muscles suffer ischemia after compartment syndrome. When pressure inside a muscle compartment is too high for too long, blood flow drops and muscle cells begin to die. The dead muscle tissue is then replaced by fibrous, scar-like tissue, which shortens and tightens the muscle so it cannot stretch, resulting in a permanent contracture. This pattern of ischemia leading to necrosis and subsequent fibrosis is what produces the fixed deformity, usually in the forearm and hand.

It isn’t a problem of nerve entrapment causing motor loss, nor a primary vascular issue, nor simply a bone fracture. Nerve entrapment would primarily affect nerve function, a vascular problem would not necessarily cause the fibrotic muscle shortening, and a fracture itself doesn’t explain the progressive contracture after ischemic injury. Prompt treatment of compartment syndrome can prevent this outcome, while established contractures often require complex reconstructive approaches.