Most common fracture associated with Volkmann's Is- chemic Contracture:

Ans. a (Supracondylar fracture of humerus). (Ref. Essential orthopedics by Maheshwari 2nd ed. 11, 30, 84)# Tight plaster of Paris cast causes impairment of circulation.# In addition, tissue edema following fracture causes increased pressure within the cast, causing impaired circulation, which can lead to ischemic contracture and latter gangrenous changes.# Although most common fracture associated with it is supracondylar fracture humerus, a tight POP is a very vital and not uncommon factor.COMPLICATIONS OF SUPRACONDYLAR FRACTURE.Volkmann's Ischaemic contracture# Flexion contractures of the fingers and wrist are caused by fibrosis of the anterior compartment of the forearm due to a missed compartment syndrome.# It can usually be prevented by avoiding immobilisation in excessive flexion of the elbow.# If greater than 90deg of flexion is required to maintain a reduction, the reduction should be held by wires and the elbow extended.# If pain persists fasciotomy is indicated.Vascular injury# Occlusion of the brachial artery is an uncommon but serious complication.# Despite the absence of a radial pulse, the arm has a good collateral supply and will not necessarily become ischaemic.# The Rx of vascular compromise is early reduction of the fracture under general anaesthetic.# If the pulse returns the arm should be monitored carefully.# Failure of circulatory return is an indication for exploration of the artery and - fracture site, with open reduction and internal fixation with wires.# An arteriogram may be obtained but should not be allowed to delay exploration.Neurological injury# The anterior interosseous nerve is most commonly affected,# Anterior Interosseous Nen/e > Median nerve > Radial nerve# Treatment is conservative for 3 months initially with good recovery expected.Malunion# Most common# Some degree of malunion is relatively common after supracondylar fracture.# A flexion or extension deformity will remodel and observation is indicated.# Varus malunion, with a "gunstock deformity".# Corrective osteotomies, if necessary, should probably be delayed until skeletal maturity.Valgus deformity- May be associated with tardy ulnar nerve palsy and may require treatment.NonunionLeast common