Neonatal Compartment Syndrome as a Result of Thromboembolic Event

Abstract

Neonatal compartment syndrome is a rare condition characterized by progressive limb ischemia and tissue necrosis manifesting at birth or in the immediate postpartum period. Early recognition of clinical features and immediate surgical intervention offer the best prognosis, but unfamiliarity with this uncommon entity often results in delayed diagnosis and catastrophic consequences, including limb amputation. We present a case in a preterm neonate who developed a proximal arterial thrombus after sustaining limb ischemia in utero. This case demonstrated that even delayed treatment with appropriate therapy can result in salvage of the limb. Clinicians should be aware of the characteristic skin findings and institute appropriate measures to determine the presence or absence of compartment syndrome.

Fig. 1.

One day of age; cyanosis and ecchymosis of the right upper extremity. Black line demarcated area of ischemic involvement.

Fig. 2.

Postoperative day 4; forearm fasciotomies.

Fig. 3.

One month of age; after negative wound pressure therapy.

Fig. 4.

Ten months of age; right forearm contracture.

Fig. 5.

Twelve-month postoperative result after soft tissue release.