Volkmann ischemic contracture is permanent shortening of forearm muscles and damage to nerves due to prolonged lack of blood flow to tissues. It occurs as a complication of undiagnosed compartment syndrome. The condition is characterized by a claw-like appearance of the fingers, hand, and wrist. Incidence is low, and it is more prevalent in children.

Volkmann ischemic contracture is typically associated with trauma such as crush injuries, burns, fractures (eg, elbow fracture, supracondylar fracture of humerus), and arterial injuries. Other causes include animal bites, bleeding disorders, excessive exercise, and medication injections. Clinical presentation is defined by five Ps: pain, pallor, pulselessness, paresthesias, and paralysis. Additional features include induration of forearm and firm tissues upon palpation.

In mild cases, contracture may involve 2 or 3 fingers, and patients may have limited or no loss of feeling. In moderate cases, all fingers are bent and the thumb is stuck in the palm; the wrist may also be bent, and there is typically some loss of feeling in the hand. In severe cases, all muscles of the forearm are affected, and the pain experienced can be disabling.

Treatment and prognosis are dependent on stage and severity at the time of diagnosis.