{"id":13346,"date":"2024-08-23T01:06:19","date_gmt":"2024-08-22T23:06:19","guid":{"rendered":"https:\/\/valintermed.com\/?p=13346"},"modified":"2024-08-23T01:06:19","modified_gmt":"2024-08-22T23:06:19","slug":"kontraktura-folkmana","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/","title":{"rendered":"Volkmann&#039;s contracture"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p>Volkmann&#039;s contracture, or acute myogenic contracture, is a serious disease characterized by compaction and shortening of soft tissues, which leads to limited mobility of joints, primarily in the upper limbs. The main etiopathogenetic mechanism of this pathology is compression of nerves and blood vessels, which can occur with injuries, especially with fractures, which result in edema, which contributes to a decrease in blood supply and tissue necrosis. Volkmann&#039;s contracture can affect both skin, tendons, and muscles, which ultimately leads to irreversible functional impairment. The problem is relevant in traumatology and rheumatology, where rapid and correct treatment is important to minimize long-term consequences for the patient.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" 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href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\" >History of the disease and interesting historical facts<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\" >Epidemiology<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\" >Genetic predisposition to this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Risk factors for the development of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Diagnosis of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Treatment<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >List of medications used to treat this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Disease monitoring<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Age-related features of the disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/folkman-s-design\/#%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\" >Questions and Answers<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\"><\/span>History of the disease and interesting historical facts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Volkmann&#039;s contracture was first described in detail in medical literature in the early 20th century, when surgeon Erwin Volkmann noted a connection between injuries, especially in athletes and military personnel, and the development of this pathology. In various sources, one can find references to contractures associated with limb injuries, but it was Volkmann&#039;s work that became fundamental in the study of this pathology. One of the interesting stories associated with the disease is a case in which successful surgical intervention allowed to restore mobility in patients, but at some points it was not possible to prevent chronic pain, which emphasizes the importance of not only surgery but also rehabilitation. Scientific research conducted in the 1950s and 1960s helped create the basis for successful treatment methods that continue to develop in modern times.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\"><\/span>Epidemiology<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>According to various epidemiological data, the overall incidence of Volkmann&#039;s contracture varies from 0.4% to 5% among trauma patients. The disease is most often observed in young men involved in contact sports or experiencing high-intensity injuries at work. Approximately 80% cases associated with limb injuries end in the development of contracture, especially if treatment is not started in time. In particular, there is a direct relationship between the severity of the injury and the resulting contracture. In addition, according to reports from the World Health Organization, as a result of the increase in the number of road accidents and industrial injuries, there is an increase in cases of this disease by 10% per year. Age is also a risk factor, since regeneration processes are usually slower in elderly patients.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\"><\/span>Genetic predisposition to this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>At present, there is no clear genetic predisposition to Volkmann&#039;s contracture, but there are a number of factors that may contribute to its development. Studies show that mutations in known genes associated with the regulation of muscle tone and neurological function may increase the risk of developing this disease. For example, changes in genes associated with muscle regeneration (MYOD1, IGF1) have also been associated with contractures. However, the exact role of these genes in the development of Volkmann&#039;s contracture is still under study, and more data are needed to draw final conclusions. It is also worth noting that susceptibility to injury, expressed in family history, may serve as an indirect sign of predisposition.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Risk factors for the development of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The main risk factors for the development of Volkmann&#039;s contracture can be divided into several categories:<\/p>\n<ul>\n<li>Physical factors: Severe injuries to the limbs, fractures and dislocations, especially in the elbow and wrist area.<\/li>\n<li>Chemical factors: Exposure to toxic substances such as solvents that may adversely affect fabrics.<\/li>\n<li>Occupational factors: Workers involved in high physical stress or hazardous working conditions are at greater risk.<\/li>\n<li>Medical factors: Individuals with circulatory conditions such as diabetes and those with autoimmune diseases.<\/li>\n<li>Age factors: Older people have a weakened recovery potential, making them more vulnerable to developing contractures.<\/li>\n<\/ul>\n<p>A combination of factors can significantly increase the likelihood of developing contracture, and this requires careful monitoring of patients with the above risks.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Diagnosis of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Diagnosis of Volkmann&#039;s contracture is based on clinical manifestations, laboratory and radiological studies. The main symptoms include:<\/p>\n<ul>\n<li>Pain in the affected area that increases with movement.<\/li>\n<li>Limited mobility of joints, especially in the elbow and wrist area.<\/li>\n<li>Pulling fingers into a fist and\/or changing their position.<\/li>\n<li>Swelling and inflammation in the area of injury.<\/li>\n<\/ul>\n<p>Laboratory tests are usually performed to rule out possible infectious processes and determine the level of inflammatory markers. Radiological examinations, including X-rays and MRI, help to assess the extent of soft tissue damage and identify possible changes in bone structure. Other diagnostic methods may include electromyography to assess the functional state of muscles and nerves. It is also important to carefully conduct a differential diagnosis, excluding other diseases, such as carpal tunnel syndrome and post-traumatic changes in the joints.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment of Volkmann&#039;s contracture involves a comprehensive approach, which depends on the stage of the disease. The following areas are usually distinguished:<\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<ul>\n<li>General treatment: Immobilization of the limb using splints and soft bandages to prevent further injury.<\/li>\n<li>Pharmacological treatment: Use of anti-inflammatory drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs), as well as pain relievers.<\/li>\n<li>Surgical treatment: In cases of severe damage, surgical correction may be required, including nerve decompression and soft tissue reconstruction.<\/li>\n<li>Other treatments: Physical therapy, including electrical stimulation, ultrasound therapy, and ROM exercises. Rehabilitation is important to minimize the risk of recurrent contractures.<\/li>\n<\/ul>\n<p>Each method requires an individual approach and can be combined depending on the clinical situation and stage of the disease.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>List of medications used to treat this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The main groups of drugs used to treat Volkmann&#039;s contracture are:<\/p>\n<ul>\n<li>NSAIDs: ibuprofen, diclofenac.<\/li>\n<li>Corticosteroids: prednisolone.<\/li>\n<li>Muscle relaxants: baclofen, cyclobenzaprine.<\/li>\n<li>Painkillers: paracetamol, opioid drugs for severe pain.<\/li>\n<li>Preparations for improving microcirculation: trental, actovegin.<\/li>\n<\/ul>\n<p>The effectiveness of treatment depends on the timeliness of therapy and the individual characteristics of the patient&#039;s body.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Disease monitoring<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Monitoring a patient with Volkmann&#039;s contracture requires regular clinical assessments as well as periodic testing of the functionality of the affected limb. Monitoring steps typically include:<\/p>\n<ul>\n<li>Assessment of the degree of mobility and the presence of pain.<\/li>\n<li>Conducting periodic X-ray examinations to monitor the condition of soft tissues and bones.<\/li>\n<li>Monitoring the effectiveness of prescribed therapy and the need for treatment adjustment.<\/li>\n<\/ul>\n<p>The prognosis for patients may vary depending on the timing of treatment and the extent of the injury. Complications may include persistent chronic pain, loss of limb function, and\/or recurrence of contracture.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Age-related features of the disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Volkmann&#039;s contracture can manifest itself differently depending on the age of the patient. Children usually have a higher chance of full recovery due to active tissue growth and repair processes. Adults experience more pronounced symptoms and a less predictable prognosis due to age-related changes in the structure of soft tissues and a lower ability to regenerate. In older people, contracture often develops more rapidly and may require more aggressive treatment methods, including multiple surgeries.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\"><\/span>Questions and Answers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><strong>What is Volkmann&#039;s contracture?<\/strong> Volkmann&#039;s contracture is a condition characterized by limited joint mobility caused by compression of nerves and blood vessels as a result of injury, which leads to shortening of soft tissues.<\/li>\n<li><strong>What are the main symptoms indicating Volkmann&#039;s contracture?<\/strong> The main symptoms include pain in the affected area, limited joint mobility, drawing in of the fingers and swelling.<\/li>\n<li><strong>How is Volkmann&#039;s contracture treated?<\/strong> Treatment includes immobilization, pharmacological therapy, surgery and rehabilitation.<\/li>\n<li><strong>Is it possible to avoid Volkmann&#039;s contracture after injury?<\/strong> Yes, timely diagnosis and treatment of injuries, as well as adequate rehabilitation can significantly reduce the risk of developing contracture.<\/li>\n<li><strong>What is the prognosis for Volkmann&#039;s contracture?<\/strong> The prognosis depends on the extent of the injury and the timeliness of treatment; with early intervention, restoration of limb function is very likely.<\/li>\n<\/ul>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Volkmann&#039;s contracture, or acute myogenic contracture, is a serious condition characterized by hardening and shortening of soft tissues, resulting in limited<\/p>","protected":false},"author":1,"featured_media":23961,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[298],"tags":[],"class_list":["post-13346","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medlibrary"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13346","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=13346"}],"version-history":[{"count":1,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13346\/revisions"}],"predecessor-version":[{"id":13572,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13346\/revisions\/13572"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media\/23961"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=13346"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=13346"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=13346"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}