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Volkmann’s Ischemic Contracture (VIC): Causes, Symptoms, Diagnosis & Management Volkmann’s Ischemic Contracture (VIC) is a severe and disabling complication resulting from untreated or prolonged compartment syndrome of the forearm. It leads to irreversible muscle and nerve damage , resulting in fixed flexion deformity of the wrist and fingers , weakness, loss of sensation, and impaired upper limb function. The condition was first described by Richard von Volkmann in 1881, highlighting the relationship between ischemia and contractures. Early recognition of compartment syndrome is essential because Volkmann Contracture is preventable if treated in time. What is Volkmann’s Ischemic Contracture? (Definition) Volkmann’s Ischemic Contracture is a permanent shortening (contracture) of forearm muscles caused by ischemia due to increased compartment pressure . It leads to: Flexion deformity of the wrist Flexion contracture of fingers Loss of hand grip Sensory defici...

Avascular Necrosis (AVN): Causes, Symptoms, Diagnosis & Management Avascular necrosis (AVN) —also known as osteonecrosis —is a progressive condition in which bone tissue dies due to a loss of blood supply . Without adequate blood flow, the bone collapses over time, ultimately leading to joint destruction. AVN most commonly affects the femoral head of the hip but can also occur in the shoulder, knee, ankle, scaphoid, or other bones. Early diagnosis is critical because early-stage AVN is reversible , whereas late-stage AVN often requires joint replacement surgery. What Causes Avascular Necrosis? AVN occurs when the blood supply to a bone is disrupted. Common causes include: 1. Trauma A fracture or dislocation can damage blood vessels, especially around the hip joint. Example: Femoral neck fractures frequently cause AVN. 2. Corticosteroid Use Long-term or high-dose steroid therapy (e.g., for asthma, autoimmune disorders) is one of the most common non-traumatic causes . 3....

NAG and SNAG Techniques: Definition, Steps, Benefits, and Evidence (Mulligan Concept) The Mulligan Concept , developed by Brian Mulligan, is one of the most widely used manual therapy approaches for treating musculoskeletal pain and restricted movement. Two of its key techniques— NAG (Natural Apophyseal Glide) and SNAG (Sustained Natural Apophyseal Glide) —are especially effective for spinal dysfunctions, joint stiffness, and movement-related pain. What Are NAG and SNAG Techniques? NAG (Natural Apophyseal Glide) NAG is a manual oscillatory mobilization applied to the facet joints (apophyseal joints) of the spine—mainly the cervical and upper thoracic levels. How it works The therapist applies a forward-upward (anterior + cranial) glide to the articular pillar. The glide is rhythmic, pain-free, and passive . It targets joint stiffness, facet hypomobility, and pain. Best for: Cervical stiffness Painful cervical ROM Cervical spondylosis Postural neck pai...

Spencer Technique: Steps, Benefits, and Uses in Shoulder Rehabilitation The Spencer Technique is a widely used osteopathic and physiotherapy mobilization method designed to improve shoulder mobility , reduce pain, and restore normal function. It consists of a series of seven specific movements that target the glenohumeral joint. Due to its effectiveness and safety, the Spencer Technique is commonly used for conditions like frozen shoulder , rotator cuff tightness , shoulder stiffness , and post-injury rehabilitation . What Is the Spencer Technique? The Spencer Technique is a joint mobilization sequence originally developed in osteopathic medicine. It helps stretch the shoulder capsule, reduce adhesions, and increase synovial fluid movement. The technique is performed in a specific order, allowing gradual restoration of mobility in a controlled and therapeutic manner. It is especially effective for: Adhesive capsulitis (frozen shoulder) Postural stiffness Reduced should...

🦴 Fractures: Types, Causes, Symptoms, and Management Introduction A fracture refers to a break in the continuity of a bone, caused by excessive force, trauma, or pathological weakening of bone tissue. Fractures are among the most common musculoskeletal injuries encountered in medical practice. Their management requires prompt diagnosis, stabilization, and a structured rehabilitation plan to ensure complete healing and restore function. According to a 2021 review in The Lancet Rheumatology , fractures represent a significant global health issue, with more than 178 million new cases reported worldwide each year ( PubMed ID: 34348191 ). Anatomy and Physiology Behind Fractures Bones are dynamic structures that can withstand substantial stress due to their composite structure of collagen (for flexibility) and calcium phosphate (for strength) . However, when external forces exceed bone strength, the structure fails, resulting in a fracture. Healing occurs in three major stages: ...

Compartment Syndrome—Definition, Pathophysiology, Diagnosis, and Physiotherapy Management 🔹 Introduction Compartment Syndrome (CS) is a serious, potentially limb- and life-threatening condition caused by increased pressure within a closed osteofascial compartment . This pressure impedes blood flow and tissue perfusion, resulting in ischemia , neuromuscular damage , and if untreated, necrosis of muscles and nerves. Each limb contains several muscle compartments surrounded by inelastic fascia . The fascia maintains compartment shape and pressure under normal conditions, but it cannot expand when internal pressure rises. When the internal pressure surpasses capillary perfusion pressure , oxygen delivery stops, leading to irreversible tissue death within hours. 🔹 Epidemiology Incidence: Approximately 3.1 cases per 100,000 population annually. Age group: Common in young males (under 35 years) due to higher trauma rates. Common sites: Lower limb: Anterior compartment...

🩸 Gangrene: Types, Causes, Symptoms, and Treatment Introduction Gangrene is a serious medical condition that occurs when body tissues die due to a loss of blood supply , infection , or trauma . It most commonly affects the extremities — such as the toes, fingers, feet, or hands — but can also occur in internal organs. In clinical practice, gangrene is considered a medical emergency because it can spread rapidly and may lead to sepsis (blood infection) or amputation if not treated promptly. Early recognition and proper management are critical to saving both tissue and life. Definition Gangrene is defined as the death of body tissue resulting from ischemia (lack of blood flow) , infection , or injury . When cells are deprived of oxygen and nutrients for too long, they die, and the surrounding area begins to decay. Causes of Gangrene Gangrene usually develops due to one or more of the following causes: Reduced Blood Supply (Ischemia): Caused by peripheral arterial dise...