[Median nerve decompression in ischemic contracture of the forearm]

Ischemic contracture of the forearm known as Volkmann contracture develops from untreated (or treated to late) compartment syndrome within the forearm. Surgery is needed if function of the extremity is to be restored after fully developed Volkmann contracture. The uniform management is accepted in our Department since 1982. Multi-stage surgical treatment is indicated, the first stage consisting of median nerve neurolysis and removal of necrotic tissues to restore physiological excursion of the nerve. A series of 48 patients (16 females, 32 males aged 5-42 years) treated between 1982 and 1995 was included in the study. Complete neurolysis of the median nerve (microsurgical within proximal 1/3 of the forearm) was done in all patients. Long-term assessment of the median nerve function was done at half year to 3 years follow-up. Symptoms of nerve entrapment indicated reoperation. The study confirmed usefulness of an early median nerve decompression for prevention of neurological complications and improvement of the extremity function.