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COVID-19 como factor contribuyente en el desarrollo de contractura isquémica de Volkmann: un reporte de caso
Tomas Maciulaitis1, Patricija Glovackaite2, Mindaugas Minderis3
1Faculty of Medicine, Institute of Clinical Medicine, Clinic of Rheumatology, Orthopedics, Traumatology and Reconstructive Surgery, Vilnius University, Vilnius, LTU.
Cureus
|December 25, 2025
Resumen
La contractura isquémica de Volkmann (CIV) es una complicación grave del síndrome compartimental. Este caso resalta los desafíos diagnósticos durante el COVID-19, enfatizando el reconocimiento temprano para prevenir daño muscular irreversible.
Área de la Ciencia:
- Ortopedia
- Cirugía Vascular
- Enfermedades Infecciosas
Sus antecedentes:
- La contractura isquémica de Volkmann (CIV) resulta de un síndrome compartimental agudo no tratado, causando deformidades irreversibles en flexión.
- La pandemia de COVID-19 presenta desafíos únicos para el diagnóstico y manejo de afecciones como el síndrome compartimental.
- El diagnóstico erróneo y el tratamiento tardío pueden conducir a resultados graves, incluida la necrosis muscular.
Objetivo del estudio:
- Informar un caso de CIV que se desarrolló durante el aislamiento por COVID-19 tras un diagnóstico erróneo.
- Discutir el posible papel del COVID-19 en la fisiopatología de la CIV.
- Enfatizar la importancia del reconocimiento oportuno del síndrome compartimental, incluso sin traumatismo.
Principales métodos:
- Reporte de caso de un hombre de 55 años con contractura de los músculos flexores del antebrazo.
- Revisión de la presentación clínica, el proceso diagnóstico y las intervenciones de tratamiento.
- Discusión de posibles mecanismos fisiopatológicos relacionados con el COVID-19.
Principales resultados:
- El paciente desarrolló CIV después de que los síntomas fueran inicialmente atribuidos a celulitis durante el aislamiento por COVID-19.
- El diagnóstico y la intervención tardíos provocaron necrosis muscular y deformidad fija en flexión.
- La descompresión quirúrgica, el desbridamiento y la neurolysis resultaron en una recuperación funcional parcial.
Conclusiones:
- El reconocimiento temprano del síndrome compartimental es crucial, independientemente del traumatismo, para prevenir la CIV.
- El COVID-19 puede contribuir al desarrollo de la CIV a través de mecanismos como el edema mediado por citoquinas y la disfunción endotelial.
- Los retrasos diagnósticos y la alteración de la cicatrización durante las pandemias exigen una mayor vigilancia clínica.
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