I WIROTE a short paper on XVolkmaiii's ischiaemic palsy in 1908, basinig my conclusionis on cases wrhich I liad either tr-eated or with which I had come in contact.Since then, I lhave met with a sufficiently large number to know that only a small proportioin of cases seen are puiblished.This is probably due to the fact that there is tho-ught to be a stigma attached to the practitioner who is involved in the treatment of such a case.One must, of course, recog- nize the potential dangers in injuries and fractutres about the elbow, but it cannot be too emplhatically stated that despite every precaution ischaemic contractures mnay occur.-Volkmann, in 1875, described a severe conttracture of the hand which he ascribed to tight bandaging in the treatment of fractures about the elbow, and he said that the deformity was due to a contracture myositis, and niot t-) a primary nerve pressure palsv.He recognized that the condition was very grave and that amputation might be nieeded.In a classical article, wrhich he published in 1881, lie reaffirmiied his belief in the ischaemic origin of thie affection, which he thought due to deprivation of alrterial blood anid to venous obstruction; contsequently, the muscle perished from want of oxygen and the pheno- menon identical with that of rigor mllortis set in.He called attention' to the important fact that ini this conldition paralysis anid contraction occurred simultaneously, whereas in primaryinerve lesions conitractions followed later.Volkmann suibmiitted that similar conitiractions lhave been k-iow-n to follow blood stasis due to compression witlh an ]4"nmarch bandage, to injuries of large vessels, and from ex-posure to extreme cold.He spoke of forcible extension of the fingers as likely to produce fracture of bones and tendons.The contributions of Volkmann and Lessa are very complete, and have required but little revision or ad'dition for fifty years.
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Rachel L. Jones (1928) studied this question.