Caouette-Laberge L, Bortoluzzi P, Egerszegi E P, Marton D
Department of Plastic Surgery, Université de Montréal Hôpital Sainte-Justine, P.Q., Canada.
Plast Reconstr Surg. 1992 Oct;90(4):621-8. doi: 10.1097/00006534-199210000-00011.
We report five cases of children born with forearm wounds associated with motor and sensory losses to the hand and forearm. Their evolution toward muscle retraction is very similar to the classic description of Volkmann's ischemic contracture. These cases should not be confused with upper extremity gangrene of the newborn or aplasia cutis congenita. Two cases of neonatal Volkmann's ischemia have already been reported in the literature and identified as such. Another very similar case has been reported as upper extremity gangrene of the newborn, and three more cases of a forearm wound with neuromuscular involvement have been reported as aplasia cutis congenita. We believe that neonatal Volkmann's ischemic contracture of the forearm should be recognized as a separate entity. Its early diagnosis may improve treatment, especially for children with recent injury, in whom intracompartmental pressures may still be elevated. Early hand therapy and splinting are mandatory to minimize late sequelae.
我们报告了5例出生时即伴有手部和前臂运动及感觉功能丧失的前臂创伤患儿。他们向肌肉挛缩发展的过程与经典描述的Volkmann缺血性挛缩非常相似。这些病例不应与新生儿上肢坏疽或先天性皮肤发育不全相混淆。文献中已经报道过2例新生儿Volkmann缺血，并已明确诊断。另1例非常相似的病例曾被报道为新生儿上肢坏疽，还有3例伴有神经肌肉受累的前臂创伤病例曾被报道为先天性皮肤发育不全。我们认为，新生儿前臂Volkmann缺血性挛缩应被视为一个独立的病种。其早期诊断可能会改善治疗效果，尤其是对于近期受伤的儿童，他们的骨筋膜室内压力可能仍处于升高状态。早期手部治疗和夹板固定对于将后期后遗症降至最低至关重要。
