Older children might try to learn everything about a single topic, such as the weather or sports, and perseverate or talk about it constantly. Sensory reactivity– An unusual reaction to certain sensory inputs such as having a negative reaction to specific sounds or textures, being fascinated by lights or movements or having an apparent indifference to pain or heat.Autistic individuals can display many forms of repetitive or restricted behavior, which the Repetitive Behavior Scale-Revised (RBS-R) categorizes as follows. Stereotyped behaviors: Repetitive movements, such as hand flapping, head rolling, or body rocking. Compulsive behaviors: Time-consuming behaviors intended to reduce anxiety, that an individual feels compelled to perform repeatedly or according to rigid rules, such as placing objects in a specific order, checking things, or handwashing. Sameness: Resistance to change; for example, insisting that the furniture not be moved or refusing to be interrupted. Ritualistic behavior: Unvarying pattern of daily activities, such as an unchanging menu or a dressing ritual. This is closely associated with sameness and an independent validation has suggested combining the two factors. Restricted interests: Interests or fixations that are abnormal in theme or intensity of focus, such as preoccupation with a single television program, toy, or game. Self-injury: Behaviors such as eye-poking, skin-picking, hand-biting and head-banging. Self-injury
Self-injurious behaviors (SIB) are relatively common in autistic people, and can include head-banging, self-cutting, self-biting, and hair-pulling. Some of these behaviors can result in serious injury or death.
Volkmanns contracture is a permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers. Passive extension of fingers is restricted and painful. Causes
Any fracture in the elbow region or upper arm may lead to Volkmanns ischemic contracture, but it is especially associated with supracondylar fracture of the humerus. It is also caused by fractures of the forearm bones if they cause bleeding from the major blood vessels of the forearm.The condition may be caused by obstruction on the brachial artery near the elbow, possibly from improper use of a tourniquet, improper use of a plaster cast, or compartment syndrome. Pathophysiology
Volkmanns contracture results from acute ischaemia and necrosis of the muscle fibres of the flexor group of muscles of the forearm, especially the flexor digitorum profundus and flexor pollicis longus. The muscles become fibrotic and shortened. Prevention
Prevention of the condition requires restoration of blood flow after injury and reduction of compartmental pressure on the muscles. Any splints, bandages, or other devices that might be obstructing circulation must be removed.A fasciotomy may be required to reduce pressure in the muscle compartment. Treatment
If contracture occurs, surgery to release the fixed tissues may help with the deformity and function of the hand. History
It is named after Richard von Volkmann (1830–1889), the 19th century German doctor who first described it, in a paper on "non-Infective Ischemic conditions of various fascial compartments in the extremities".