Download PDF
AJP Rep 2014; 04(02): e77-e80
DOI: 10.1055/s-0034-1382257
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neonatal Volkmann Ischemic Contracture: Case Report and Review of Literature

Hitesh Agrawal
1   Department of Pediatrics, John H Stroger Jr. Hospital of Cook County, Chicago, Illinois
,
Gunjan Dokania
1   Department of Pediatrics, John H Stroger Jr. Hospital of Cook County, Chicago, Illinois
,
Shou-Yien Wu
2   Division of Neonatology, John H Stroger Jr. Hospital of Cook County, Chicago, Illinois
3   Department of Neonatology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

29 March 2014

29 April 2014

Publication Date:
24 June 2014 (online)

   Permissions and Reprints

Abstract

Background Neonatal Volkmann ischemic contracture in newborns is a devastating condition with lifelong consequences.

Case Report We report a neonate born with necrotic skin lesions and bullae on right dorsal thenar aspect of hand, who subsequently developed compartment syndrome requiring fasciotomy.

Review and Conclusion Necrotic skin lesions with/without swelling, bullae are invariably present at birth in these patients and should be recognized as a sentinel finding of underlying tissue ischemia/compartment syndrome. Early recognition and prompt surgical intervention can be limb saving. A range of radiologic abnormalities and contractures were noted in upto 84% of such patients followed long term. Hence, we recommend close follow-up until occurrence of epiphyseal fusion in these patients.

Keywords

neonatal Volkmann ischemic contracture - neonatal extremity gangrene - skin necrosis - contracture
 

  • References

  • 1 Volkmann R. Die ischaemischen muskellahmungen and kontrakturen. Zentralbl Chir 1881; 8: 801-803
    PubMedGoogle Scholar
  • 2 Allen LM, Benacci JC, Trane III RN, Driscoll RJ. A case of neonatal compartment syndrome: importance of early diagnosis in a rare and debilitating condition. Am J Perinatol 2010; 27 (2) 103-106
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Armstrong AP, Page RE. Intrauterine vascular deficiency of the upper limb. J Hand Surg [Br] 1997; 22 (5) 607-611
    CrossrefPubMedGoogle Scholar
  • 4 Caouette-Laberge L, Bortoluzzi P, Egerszegi EP, Marton D. Neonatal Volkmann's ischemic contracture of the forearm: a report of five cases. Plast Reconstr Surg 1992; 90 (4) 621-628
    CrossrefPubMedGoogle Scholar
  • 5 Cham PM, Drolet BA, Segura AD, Esterly NB. Congenital Volkmann ischaemic contracture: a case report and review. Br J Dermatol 2004; 150 (2) 357-363
    CrossrefPubMedGoogle Scholar
  • 6 Christiansen SD, Desai NS, Pulito AR, Slack MR. Ischemic extremities due to compartment syndromes in a septic neonate. J Pediatr Surg 1983; 18 (5) 641-643
    CrossrefPubMedGoogle Scholar
  • 7 Dahlin LB, Erichs K, Rosberg HE. Compartment syndrome in the forearms of two neonates. Scand J Plast Reconstr Surg Hand Surg 2009; 43 (1) 58-60
    CrossrefPubMedGoogle Scholar
  • 8 Engel J, Heim M, Tsur H. Late complications of neonatal Volkmann's ischaemia. Hand 1982; 14 (2) 162-163
    PubMedGoogle Scholar
  • 9 Isik C, Demirhan A, Karabekmez FE, Tekelioglu UY, Altunhan H, Ozlu T. Forearm compartment syndrome owing to being stuck in the birth canal: a case report. J Pediatr Surg 2012; 47 (11) e37-e39
    PubMedGoogle Scholar
  • 10 Kline SC, Moore JR. Neonatal compartment syndrome. J Hand Surg Am 1992; 17 (2) 256-259
    CrossrefPubMedGoogle Scholar
  • 11 Léauté-Labrèze C, Depaire-Duclos F, Sarlangue J , et al. Congenital cutaneous defects as complications in surviving co-twins. Aplasia cutis congenita and neonatal volkmann ischemic contracture of the forearm. Arch Dermatol 1998; 134 (9) 1121-1124
    CrossrefPubMedGoogle Scholar
  • 12 Pavlidis E, Spagnoli C, Duca M, Ormitti F, Magnani C, Pisani F. Neonatal forearm compartment syndrome: look for cerebral stroke. J Pediatr 2014; 164 (2) e1
    CrossrefPubMedGoogle Scholar
  • 13 Plancq MC, Buisson P, Deroussen F, Krim G, Collet LM, Gouron R. Successful early surgical treatment in neonatal compartment syndrome: case report. J Hand Surg Am 2013; 38 (6) 1185-1188
    CrossrefPubMedGoogle Scholar
  • 14 Ragland III R, Moukoko D, Ezaki M, Carter PR, Mills J. Forearm compartment syndrome in the newborn: report of 24 cases. J Hand Surg Am 2005; 30 (5) 997-1003
    CrossrefPubMedGoogle Scholar
  • 15 Raimer L, McCarthy RA, Raimer D, Colome-Grimmer M. Congenital Volkmann ischemic contracture: a case report. Pediatr Dermatol 2008; 25 (3) 352-354
    CrossrefPubMedGoogle Scholar
  • 16 Rios M, Ribeiro C, Soares P , et al. Volkmann ischemic contracture in a newborn. BMJ Case Rep 2011; 2011: 2011
    PubMedGoogle Scholar
  • 17 Silfen R, Amir A, Sirota L, Hauben DJ. Congenital Volkmann-Lesser ischemic contracture of the upper limb. Ann Plast Surg 2000; 45 (3) 313-317
    CrossrefPubMedGoogle Scholar
  • 18 Tsujino A, Hooper G. Neonatal compression ischaemia of the forearm. J Hand Surg [Br] 1997; 22 (5) 612-614
    CrossrefPubMedGoogle Scholar
  • 19 Tsur H, Yaffe B, Engel Y. Impending Volkmann's contracture in a newborn. Ann Plast Surg 1980; 5 (4) 317-320
    CrossrefPubMedGoogle Scholar
  • 20 Van der Kaay DC, Horsch S, Duvekot JJ. Severe neonatal complication of transverse lie after preterm premature rupture of membranes. BMJ Case Rep 2013; 2013: 201
    PubMedGoogle Scholar
  • 21 Fee HJ, McAvoy JM, Dainko EA. Neonatal arterial occlusion. J Pediatr Surg 1977; 12 (5) 711-713
    CrossrefPubMedGoogle Scholar
  • 22 Wiseman NE, Briggs JN, Bolton VS. Neonatal arterial occlusion with ischemic limb gangrene. J Pediatr Surg 1977; 12 (5) 707-710
    CrossrefPubMedGoogle Scholar
  • 23 Giacoia GP. High-dose urokinase therapy in newborn infants with major vessel thrombosis. Clin Pediatr (Phila) 1993; 32 (4) 231-237
    CrossrefPubMedGoogle Scholar
  • 24 Ricciardelli E, Morgan RF, Lin KY. In utero brachial artery thrombosis: limb salvage with postnatal urokinase infusion. Ann Plast Surg 1995; 34 (1) 81-83
    CrossrefPubMedGoogle Scholar