THE RELIEF OF TRAUMATIC ARTERIAL SPASM IN THREATENED VOLKMANN'S ISCHAEMIC CONTRACTURE

Abstract

1. Three cases of traumatic arterial spasm are reported. 2. In each case there was increased tension in a neighbouring myofascial compartment. 3. The cause of this tension was oedema, possibly supplemented in one case by haematoma. 4. Release of tension by splitting the sheath was followed by relaxation of the artery. 5. It is suggested that tension in a fascial compartment may provide the stimulus that maintains arterial spasm and that the consequent ischaemia aggravates the oedema, so that a vicious circle is established. 6. It is further suggested that if spasm persists in spite of the usual measures, including exploration of the artery, the distal myofascial compartment should be decompressed. Division of the deep fascia of the cubital or the popliteal fossa is not enough. 7. Such persistent arterial spasm is uncommon, and further observations are needed to define the significance of increased tension in a distal myofascial compartment.