Impending Volkmannʼs Contracture in a Newborn

Forearm Compartment Syndrome in the Newborn: Report of 24 Cases

“…The spectrum of presentation varies and may range from a local skin lesion to a swollen forearm to distal gangrene. The skin lesion was present in most reported cases 1,[3][4][5][6][7][8]10,12,14 and in all of our cases, but the association of a skin lesion and underlying compartment syndrome often is not appreciated and emergency fasciotomy rarely has been performed. 15 The skin lesion is obvious and often is the focus of treatment in the nursery.…”

“…1,3,5,6,8,19 This is consistent with the 24 patients reported here and in 16 similar patients described in various case reports and smaller series in the literature. [1][2][3][4][5][6]8,10,20,30 We believe the diagnosis of cutis aplasia is confusing when it is applied to forearm skin lesions and that it is best reserved for the classic scalp involvement. One patient in this series did have a sibling with the diagnosis of cutis aplasia of the scalp.…”

“…Cantaboni and Taveggia 1 believed this represented a form of cutis aplasia and Lightwood 2 called it neonatal sclerema; Hensinger, 3 Tsur et al, 4 Caouette-Laberge et al, 5 Leauté-Labrèze et al, 6 Henssge and Linka, 7 Perricone and Granata, 8 Silfen et al, 9 Kline and Russell Moore, 10 Tsujino and Hooper, 11 and Cham et al 12 recognized vascular compromise and compartment syndrome as the basis for the condition of the soft tissue. Rombouts et al 13 reported on the neurologic findings and related them to compression palsy.…”

Volkmann ischemic contracture in a newborn

“…Volkmann ischemic contracture syndrome was first described by Richard von Volkmann in 18691 and consists of the presence of neuromuscular and skin lesions originating in a rapid increase of interstitial pressure in a closed anatomic space 1–8. It is most commonly found in children or adults who have suffered intense trauma, prolonged external compression, excessive exercise, burns and animal bites 1 2.…”

“…The lesions are present at birth and characterised as bullae that quickly burst into deep ulcers evolving to necrotic areas 1–4 8–10. Later, muscular atrophy becomes evident with contraction and flexing of the fingers and claw-like hand position 2 4 9.…”