Ischaemic Contracture in an Infant’s Forearm – A Case Report

Abstract

We present a case of a gradually developing ischaemic contracture of the forearm muscles of an infant who developed without any trauma or acute gangrene at birth. Release of the middle and ring finger digitorum profundus muscles and pronator quadratus at 2 years of age corrected the deformity. Histopathology showed no evidence of fibromatosis or any other tumor. Although a dynamic splint was used to maintain the range of motion, the range of the middle finger motion deteriorated gradually 2 years after surgery. Though the pathogenesis of this problem was unclear, we assume that it was caused by fibrosis of muscles as a result of bleeding before or during delivery.

Volkmann ischemic contracture in a newborn

“…In this case, as with most documented cases,1–16 sequelae are atrophy, scarring, mobility limitation and probable limitation of bone growth. The study by Ragland et al showed skeletal involvement in 18 cases and nerve lesions in 16 out of 24, with neurological recovery in four 9…”

“…The histological characteristics are unspecified and the necrosis severity is related to ischemia duration 4. In the cases previously described, there is no evidence of compression in other anatomical regions 1–16. However, in the present case a few discreet skin lesions were detected in other regions that may be related to slight compression from conflict of intrauterine compartment.…”

“…Congenital Volkmann ischemic contracture, also known as neonatal compartment syndrome, is a very rare condition. In this age group there are only about 50 documented cases, all affecting an upper limb, even though it may occur in the lower limbs 1–16…”

A Case of Neonatal Compartment Syndrome: Importance of Early Diagnosis in a Rare and Debilitating Condition

“…3 Fewer than 100 cases have been reported in the literature. 4 In almost all reported cases, NCS is not associated with any type of fracture or dislocation. The exact etiology remains unknown, but the insult occurs before birth.…”