Strangling Congenital Constriction Ring Band of the Forearm with Fracture: A Rare Case Report

Angelis, Stavros; Vynichakis, Georgios; Trellopoulos, Angelos; Mirtsios, Hristos; Michelarakis, John

doi:10.7759/cureus.4189

Cited by 3 publications

(5 citation statements)

References 10 publications

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“…Band release was performed on day 4 and the fracture was reduced and immobilized. Circulation improved but the patient deceased on day 16 due to vascular distress [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…While fractures may be considered on the same spectrum of pseudarthrosis and other osseous defects, the chronicity and natural history of more acute fractures is distinct from true pseudarthroses. There are only two reports in the literature of isolated extremity fractures in the setting of a congenital constriction band (CCB) [ 18 , 19 ]. Here, we report a small case series on the presentation and management of three patients at our institution who were identified to have an upper or lower extremity fracture at the site of a CCB shortly after birth.…”

Section: Introductionmentioning

confidence: 99%

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Fractures in the Setting of Constriction Band Syndrome: A Case Series of Three Patients with Extremity Fractures at the Site of a Constriction Band

et al. 2022

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Constriction band syndrome (CBS) is a rare condition where fibrous bands constrict one or more parts of the fetus with varying manifestations such as autoamputation, acrosyndactyly, and neuropathy. However, isolated extremity fractures in the setting of constriction band syndrome are even more rare, with only two reported cases in the literature. There are few guidelines on the management of CBS due to small case numbers, the variability of presentation between patients, and the lack of consensus on etiology and pathogenesis. In this small case series, we describe the presentation and management of three patients at our institution with extremity fractures at the site of severe constriction bands with neurologic injuries or vascular compromise. We also review the literature on this topic to provide further context. Intramedullary stabilization of the fracture with a k-wire allowed for soft tissue healing in two of our patients.

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“…Band release was performed on day 4 and the fracture was reduced and immobilized. Circulation improved but the patient deceased on day 16 due to vascular distress [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fractures in the Setting of Constriction Band Syndrome: A Case Series of Three Patients with Extremity Fractures at the Site of a Constriction Band

et al. 2022

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“…Most of the children presented in the first week of life in the reported literature; three children with limb-threatening deep constriction bands in the leg with swollen feet were managed at 3 h, 18 h and 7 days after birth [9,10,11]. Early release of the band (even bedside) on day 2 and 4 of life due to limb-threatening vascular compromise is reported [8,17]. In our patients, none had circulatory compromise or severe oedema in the distal leg or foot requiring urgent surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Tibial involvement in CBS without pseudarthrosis may present as intramedullary sclerosis [3], cystic lesions [4] and bowing [5,6]. Fracture of tibia and forearm bones in new-born children at the level of constriction bands has been reported [7,8]; a late presentation with pseudarthrosis of the tibia is much more frequent [9][10][11][12]. However, due to the paucity of literature, clear-cut criteria about the management of pseudoarthrosis of the tibia in patients with CBS is lacking; there are only case reports in the literature [10].…”

Section: Introductionmentioning

confidence: 99%

The spectrum of tibial pseudarthrosis with constriction band syndrome in children

Naik

Shah

Gupta

2021

Journal of Pediatric Orthopaedics B

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Constriction band syndrome (CBS) may be rarely associated with pseudarthrosis of tibia. Published literature includes only case reports. We evaluated the outcome of children with frank pseudarthrosis of the tibia with CBS and compared our results with other reported cases. We aimed to formulate a clinical classification of tibial involvement in CBS on the basis of the treatment guidelines. Seven patients with the presence of one or more constriction bands and radiological signs of tibial pseudarthrosis were included in the study. Eight reported cases of CBS with tibial involvement with management and follow-up details were reviewed. Only two tibial pseudarthrosis united spontaneously after the release of the constriction band. Two patients underwent simultaneous correction of tibial deformity and nailing with band release, one of which needed bone grafting for the pseudarthrosis union. Three patients subsequently needed an excision of tibial pseudarthrosis with nailing to achieve tibial union, two of them had autologous bone grafting along with nailing. Additional procedures were required for the correction of foot deformity and limb length discrepancy. Our findings were similar to the reported cases. The pseudarthrosis of the tibia with CBS does not always heal following band release. Additional surgeries may be required for persistent pseudarthrosis, limb length discrepancy and residual foot deformities. A functional and radiological classification is proposed for the treatment of tibial pseudarthrosis with CBS.

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“…Pseudorarthrosis of the radius or ulna as signs of neurofibromatosis are rarely diagnosed in the neonatal period. Hyperostosis of the forearm (Caffeys disease) is among the extremely rare cases with x-ray similar to neonatal fracture [66][67][68][69][70] (Figures 23 and 24).…”

Section: Fractures Of Forearmmentioning

confidence: 99%

Neonatal Fractures

Laliotis¹

2024

Current Fracture Care

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A neonatal fracture is a severe complication creating problems regarding diagnosis and appropriate management. Diagnosis from the neonatologist occasionally is difficult. A paediatric orthopaedic surgeon is required to evaluate the neonate, and confirm diagnosis and treatment. Clavicle fracture is the most common injury that must be differentiated occasionally from neonatal brachial plexus palsy. The clinical signs are crepitus, swelling, bony prominence, with the restriction of the movements of the arm. Occasionally, the fracture is diagnosed later. Clavicle pseudoarthrosis is a rare dysplasia. Fracture of the femur or the humerus presents with swelling, crepitus and deformity of the limb, creating difficulties in clothing, bathing and feeding. Most commonly are found in urgent caesarean delivery or complicated dystocia with over-weighted neonates. Bone fragility diseases (osteogenesis imperfecta, hypophosphatasia, arthrogryposis) are diagnosed from neonatal fractures. Conservative treatment with immobilization is the method of choice. Extremely rare is surgical treatment. Premature and low-weighted babies are in high risk to sustain fractures. Epiphyseal fractures of the distal femoral or humeral epiphysis are rare fractures, difficult to be diagnosed initially. They require immediate reduction to avoid permanent lesion of the growth plate. Fractures of forearm, tibia or vertebrae are extremely rare and associated with a bone fragility disease.

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Strangling Congenital Constriction Ring Band of the Forearm with Fracture: A Rare Case Report

Cited by 3 publications

References 10 publications

Fractures in the Setting of Constriction Band Syndrome: A Case Series of Three Patients with Extremity Fractures at the Site of a Constriction Band

Fractures in the Setting of Constriction Band Syndrome: A Case Series of Three Patients with Extremity Fractures at the Site of a Constriction Band

The spectrum of tibial pseudarthrosis with constriction band syndrome in children

Neonatal Fractures

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