Pseudo-Volkmann's Contracture Due to Tethering of Flexor Digitorum Profundus to Fractures of the Ulna in Children

Abstract

We studied seven children with the unusual complication of pseudo-Volkmann's contracture due to tethering of the flexor digitorum profundus to fractures of the ulna. It was detected 2 days to 16 years after closed reductions of fractures of the shafts of the radius and ulna. The children did not have nerve palsies or undue pain after the reductions. Normal length, excursion, and function of the flexor digitorum profundus was restored by untethering the muscle and its tendons from the ulnar fracture by early manipulation or by late localized myotenolysis. We recommend that the passive range of motion of all fingers be routinely checked immediately after closed reductions of fractures of the radius and ulna. If muscle tethering is detected, the fracture is remanipulated to release the muscle. If the muscle is still tethered, then surgical release, through a small incision, is required.