[Ischemic contractures of the forearm and hand]

This article gives an overview of anatomy, pathophysiology, aetiology, and diagnosis of the compartment syndrome and the resulting ischaemic necrosis of the upper extremity. The relation between compartment syndrome and infection is pointed out. Whereas the therapy of a manifest compartment syndrome is rather uniform consisting in decompression of the involved fascial compartment, the treatment of the ischaemic muscle necrosis is manifold. It depends upon severity and location of the disease. Only the mildest involvement can be treated by nonoperative measures. Surgically, neurolysis, excision of necrotic musculature and scar, muscular slide, elongating tenotomy, tendon transposition and free vascularized muscle transplantation have to be considered. Only the availability of all treatment options gives the surgeon the choice of treatment that fits the demands of the individual patient best.