Volkmann's contracture / by Leonard S. Dudgeon.

  • Dudgeon, Leonard S., 1876-1938.
Date:
1902
Catalogue details

Licence: In copyright

Credit: Volkmann's contracture / by Leonard S. Dudgeon. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    7 VOLKMANN’S CONTRACTURE. This deformity, which was first described by Professor Richard Volkmann1 in 1875, has since received little attention from the medical profession in this country. There is little to be found on the subject in books on surgery (either past or present) or on deformities, or, in fact, anywhere in the litera- ture, except in a few scattered papers of which those by Page, Littlewood, and Barnard are the best; full reference will be given to these papers later. This form of contracture is said to be rare. This statement, I think, is incorrect; it is far more probable that it is only rare in the sense that there is a scaroity of literature on the subject. I have con- sidered it best to give first the four cases which have come under my own notice and which are recorded here for the first time ; secondly, to give a summary of all the cases in the literature as far as it has been possible to do so ; and, finally, to discuss the deformity at length. Case 1.—The patient, a child, aged five years, was admitted into St. Thomas’s Hospital under the care of Mr. H. H. Glutton on Sept. 15th, 1897. At Christmas, 1896, she had fallen downstairs and had broken her right arm just above the elbow-joint. She was taken at once to a medical man, by whom the fracture was set and the arm was put up in splints. According to the relatives there was no trace of a wound when the arm was first seen. Two days later they called in another medical man who took the splints off and found that there was a considerable wound over the seat of the fracture and a great deal of inflammation present, while the fingers were swollen and discoloured. The arm was dressed but the splints were not reapplied. Wasting and contracture seem to have set in during the process of healing, which appears to have been very slow and not finally completed until about six months after the original accident. On admission into St. Thomas’s Hospital the condition was noted as follows : “The whole right arm is wasted, the forearm especially, consisting of little more than skin and bone. It is hold pronated midway between pronation and supinal ion and slightly flexed on the arm. The hand is flexed at right angles to the forearm ; the fingers and thumb are slightly flexed on the palm. Extending right across the elbow-joint is a large scar which has produced considerable contraction in the surrounding skin. At the inner end of