Volkmann's ischemia.

The posttraumatic syndrome of Volkmann's ischemia and infarction is the end result of compromise of muscle perfusion within the osteofascial compartments of the forearm. The "closed space" arrangement as well as the particular neurovascular anatomy make the flexor forearm muscles particularly susceptible to the cyclic derangement of blood flow, which ultimately results in muscle ischemia and infarction. Only strong clinical awareness will allow appropriate early diagnosis and treatment by surgical decompression. Fasciotomy and epimysiotomy serve to interrupt the cycle. The successful treatment of Volkmann's ischemia requires an understanding of the pathophysiologic mechanisms at work, an appreciation of the subtleties of the clinical presentation, and strong grounding in the details of forearm anatomy and techniques of surgical decompression.