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Neonatal Limb Compartment Syndrome: A Comprehensive Review
Ibrahim Cherry1, Diane Franck1, Frederic Urbain2
1Department of Pediatric Plastic Surgery, Hôpital Universitaire des Enfants Reine Fabiola - Hôpitaux Universitaires de Bruxelles, Brussels, Belgium.
The Journal of Hand Surgery
|December 9, 2023
Summary
Neonatal limb compartment syndrome (NLCS) is a rare condition. Early surgical decompression within 24 hours offers the best outcomes, minimizing long-term sequelae.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Orthopedics
Background:
- Neonatal limb compartment syndrome (NLCS) is a rare but serious condition.
- Misdiagnosis can delay critical treatment due to low clinical suspicion.
Purpose of the Study:
- To review literature on NLCS, identifying common themes and evidence gaps.
- To guide future research and improve clinical management.
Main Methods:
- Comprehensive literature search in PubMed, Scopus, and Google Scholar.
- Two independent reviewers extracted data from 43 reports (86 cases) published 1980-2021.
- Data included delivery history, complications, diagnosis timing, lesion location, and management.
Main Results:
- NLCS predominantly affected the upper extremity (95.3%) with a 6:7 male-to-female ratio.
- Key clinical features: sentinel skin lesions (94.2%), swelling (41%), cyanosis (89.5%), and necrotic fingers (7%).
- Nonsurgical management (68.6%) was more common than surgical decompression (32.6%).
Conclusions:
- Sentinel skin lesions and flaccid paralysis are crucial diagnostic clues for NLCS.
- Imaging (radiography, Doppler, MRI) did not aid NLCS management and could delay treatment.
- Early decompression (<24 hours) resulted in the lowest sequelae rate (16.6%) compared to late fasciotomy or nonsurgical management.
