Richard von Volkmann

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.

Volkmann 1875 tibia fractures

** 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


References


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Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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