Richard von Volkmann

Richard von Volkmann (1830-1889) German surgeon and author of poetry and fiction.

Volkmann wrote poetry under the name Richard Leander including “Dreams by French Firesides” [Traeumereien an franzoesischen Kaminen]

Biography

• Born August 17, 1830, Leipzig
• Died November 28, 1889

Medical Eponyms

Volkmann triangle (1875)

[*Earle-Volkmann triangle] – the avulsed posterior edge of the distal tibia (posterolateral tibial lip), in cases of traumatic fracture-dislocation of the ankle. In fact…Volkmann described anterior fragment disruption in 1875.

** Fig 7: schematic drawing of various forms of tear-off fractures of the lateral part of the lower epiphysis of the tibia observed by me with simultaneous detachment of the malleolus internus

It was Henry Earle (1789 – 1838) in 1829 who first described the avulsed posterior edge of the distal tibia in a publication relating to a 53-year-old man who sustained a severe injury of his right ankle:

There was found to be dislocation of the tibia forwards, and a comminuted fracture of the fibula. The muscles of the limb were acting spasmodically with great violence. The dislocation of the tibia was reduced, and the leg put up in splints. Twelve leeches to be applied to the part, and cold cloths…The tibia dislocated forwards, with a small portion of its posterior edge fractured and retained in situ – considered perfectly novel.

Earle 1829

Volkmann ischaemic contracture (1881)

Flexion contracture secondary to external pressure causing irreversible necrosis of muscle tissue. Most commonly seen in the hand, resulting in a claw hand

For years I have called attention to the fact that the pareses and contractures of limbs following application of tight bandages are caused not by pressure paralysis of nerves, as formerly assumed, but by the rapid and massive deterioration of contractile substance and by…reactive and regenerative processes. The paralysis and contracture should be regarded as a purely myogenic

Volkmann 1881

Hueter-Volkmann law (1862)

Conceptual description of how immature bones grow and remodel via both intramembraneous and endochondral ossification. An orthopaedic rule that states compression forces inhibit growth and tensile forces stimulate growth.

In 1862 whilst studying anatomy, Carl Hueter (1838 – 1882) published his ‘Anatomic studies on the joints of the extremities in newborns and adults’. He deduced that:

…the changes of the joint surfaces are preferably caused by a relative greater growth of the bony parts which are under relatively less pressure

Hueter 1862

Virchow, also in 1862 published his ‘Surgical experiences concerning bone deformities and bone growth’. He stated that:

surgeons and orthopaedists have always been convinced that osseous tissue is a mobile form changing fabric…the periosteum places new bone layer by layer, whilst on the inside increasing pressure pushes away the old bone which atrophies with pressure…alterations in the growth of long bones are as a result of tension and compression on the epiphyseal plate

Volkmann 1862

• Hueter-Volkmann law with Carl Heuter – conceptual description of immature bone growth – “compression forces inhibit growth and tensile forces stimulate growth“
• Volkmann splint – for a fracture of the lower limb with a foot-piece and two lateral supports
• Volkmann disease (or Volkmann’s syndrome I) – Congenital talus luxation or tibiotarsal dislocation resulting in characteristic foot deformity.
• Volkmann abscess – abscess of cervical vertebral secondary to tuberculosis. The abscess was removed using a Volkmann spoon…

Major Publications

• Volkmann R. Ein Winkelmaß für das Hüftgelenk (Coxankylometer) [A goniometer for the hip joint]. Archiv fur Klinische Chirurgie. 1862; 2: 294–299.
• Volkmann R. Chirurgische Erfahrungen über Knochenverbiegung und Knochenwachstum [Surgical experiences about bone deformities and bone growth]. Archive for pathological anatomy and physiology and clinical medicine. 1862; 24(5-6): 512–540. [Hueter-Volkmann law]
• Volkmann R. Zur Ätiologie der Klumpfüsse [Etiology of the equinovarus]. Deutsche Klinik. 1863;15:329.
• Volkmann R. Über den Verlust der Pronations- und Supinationsbewegungen nach Brüchen am Vorderarm [About the loss of pronation and supination capability after forearm fractures]. Berliner Klinische Wochenschrift. 1867; 5: 193.
• Volkmann R. Ein Fall von hereditärer congenitaler Luxation beider Sprunggelenke. Deutsche Zeitschrift für Chirurgie 1873; 2(6): 538–542 [Volkmann’s syndrome I]
• Volkmann R. Beiträge zur Chirurgie: anschliessend an einen Bericht über die Thätigkeit der chirurgischen Universitäts-klinik zu Halle im Jahre 1873. Published 1875 [Volkmann triangle 104-106]
• Volkmann R. Über die Anwendung der Esmarch’schen blutsparenden Verfahrens bei Exartikulation des Hüftgelenkes [About the application of the Esmarch’s blood saving technique for the exarticulation of the hip joint]. Zentralblatt für Chirurgie. 1874; 1: 65–66.
• Volkmann R. Professor Volkmann on antiseptic osteotomy. 1875
• Volkmann R. Über den antiseptischen Okklusivverband und seinen Einfluss auf den Heilungsprozess der Wunden [About antiseptic occlusive bandages and their influence on the healing process of wounds]. Volkmanns Sammlung klinischer Vorträge II Serie. 1875; 96: 759–812.
• Volkmann R. Die perforierende Tuberkulose der Knochen des Schädeldaches [Perforating tuberculosis of the skull bones]. Zentralblatt für Chirurgie. 1880; 7: 3–7.
• Volkmann R. Ischämische Muskellähmungen und -kontrakturen [Ischemic muscle paralysis and contractures]. Zentralblatt für Chirurgie. 1881; 8: 801–803. [Volkmann ischaemic contracture]

References

Biography

Eponymous terms

• Earle H. Simple, succeeded by compound dislocation forwards, of the inferior extremity of the tibia, with fracture of its posterior edge, comminuted fracture of the fibula, amputation of the leg, and death. Lancet 1829; 12(302): 346-348
• Hueter C. Anatomische Studien an den Extremitätengelenken Neugeborener und Erwachsener [Anatomic studies on the joints of the extremities in newborns and adults]. Virchow Arch. 1862;26:484–519.
• Schober KL. [Our surgical heritage. Richard von Volkmann on the 150th anniversary of his birth on 17 August 1980]. Zentralbl Chir. 1980;105(24):1635-43
• Neumaier Probst E, Maas R, Meenen NM. Isolated fracture of the posterolateral tibial lip (Volkmann’s triangle). Acta Radiol. 1997;38(3):359-62.
• Hach W, Hach V. [Richard von Volkmann and the Surgical School of Halle in 1867 to 1889]. Zentralbl Chir. 2001 Oct;126(10):822-7.
• Bartonícek J. Avulsed posterior edge of the tibia. Earle’s or Volkmann’s triangle? J Bone Joint Surg Br. 2004 Jul;86(5):746-50.
• Mostofi SB. Who’s Who in Orthopedics. Springer; pp 344-345. 2005 edition
• Willy C et al. Richard von Volkmann: Surgeon and Renaissance Man. Clin Orthop Relat Res. 2008 Feb; 466(2): 500–506.
• Volkmann Poetry as Richard Leander – Reveries at French Firesides ~ Traeumereien an franzoesischen Kaminen.

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