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      Flail extremity resulting from constriction band syndrome: Neurovascular implications and surgical management

      case-report

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          Abstract

          Purpose: Constriction band syndrome afflicting in utero development can lead to devastating and possibly fatal outcomes. A lack of consensus regarding noninvasive testing and surgical modalities is likely secondary to the continued poorly understood pathology. Methods : We provide a case report of a 6-month-old boy who presented with a functional, nonsensate upper limb after surgical release of midhumeral banding at 3 months of age. Results: Exploration revealed intact, albeit atrophic, peripheral nerves with brachial artery disruption above the elbow. Sural nerve grafting was performed and 2-year follow-up demonstrated return of protective sensation in the median nerve distribution with minimal motor return. Conclusion: This case demonstrates that nerves present distal to the original soft tissue insult oppose the idea of failure of nerve formation. Early nerve grafting at the time of initial Z-plasty release may serve to improve long-term functional outcomes.

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          Most cited references28

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          AMNIOCHORIONIC MESOBLASTIC FIBROUS STRINGS AND AMNIONIC BANDS: ASSOCIATED CONSTRICTING FETAL MALFORMATIONS OR FETAL DEATH.

          R TORPIN (1965)
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            Congenital ring-constrictions.

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              Fetal vascular disruptions: mechanisms and some resulting birth defects.

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                Author and article information

                Journal
                Case Reports Plast Surg Hand Surg
                Case Reports Plast Surg Hand Surg
                ICRP
                icrp20
                Case Reports in Plastic Surgery & Hand Surgery
                Informa Healthcare
                2332-0885
                2014
                3 December 2014
                : 1
                : 1
                : 29-32
                Affiliations
                [ a ]Division of Plastic, Reconstructive & Hand Surgery, University of Cincinnati Medical Center , 231 Albert Sabin Way, Cincinnati, OH 45267, USA
                [ b ]Divison of Plastic Surgery, Cincinnati Children’s Hospital Medical Center , 3333 Burnet Avenue, Cincinnati, OH 45229, USA
                [ c ]Division of Plastic and Reconstructive Surgery, Shriners Hospital for Children, Cincinnati Children’s Hospital Medical Center , 3333 Burnett Ave, Cincinnati, OH 45229, USA
                Author notes
                Correspondence: Kevin P. Yakuboff, MD, Professor, Division of Plastic and Reconstructive Surgery, Shriners Hospital for Children, Cincinnati Children’s Hospital Medical Center , 3333 Burnett Ave, Cincinnati, OH 45229, USA. +1 513 636 7181. yakuboff@ 123456ix.netcom.com
                Article
                962538
                10.3109/23320885.2014.962538
                4627103
                44ea1da0-e4a3-45b9-a6d9-c1c9fb8e93dd
                © 2014 The Author(s). Published by Informa Healthcare.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 3, Tables: 0, Equations: 0, References: 29, Pages: 4
                Product
                Categories
                Case Report

                constriction band syndrome,streeter’s syndrome

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