[Free re-innervated Latissimus Dorsi musculocutaneous flap for treat congenital Volkmann ischemic Contracture: a case report]. 2014

A Trimaille, and N Kerfant, and C Le Rouzic-Dartoy, and A Henry, and W Hu
Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France. Electronic address: alexandra.trimaille@wanadoo.fr.

OBJECTIVE Congenital Volkmann ischemic contracture is a rare entity. The neonate presents nerve palsy, cutaneous and muscular necrosis of the forearm. METHODS We report a case of a newborn who presented with necrotic subcutaneous tissue of the right forearm and absence of active flexion and extension of the wrist and fingers. She was initially treated with debridement of necrotic tissues and orthosis of the wrist. Latissimus dorsi free flap was used for forearm reconstruction at age of 7months. The thoracodorsal nerve was anastomosed with a motor branch of the median nerve. The proximal part of the muscle was fixated to the lateral epicondyle of humerus, and the distal part of muscle was sutured with a flexor digitorum tendons and radial extensor carpi. The cutaneous component of the flap was used to cover a defect of soft tissue of the forearm. RESULTS At age of 12 months, the patient has a good two-hand function with a pollici digital clamp of the right hand. She also has a recovery of active wrist extension and fingers flexion. CONCLUSIONS Free re-innervated latissimus dorsi muscle transfer is an alternative to restore a useful hand function in case of congenital Volkmann ischemic contracture.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D054061 Ischemic Contracture A type of permanent damage to muscles and nerves that results from prolonged lack blood flow to those tissues. It is characterized by shortening and stiffening of the muscles. Contracture, Volkmann,Volkmann Contracture,Volkmann's Ischemic Contracture,Contracture, Ischemic,Contracture, Volkmann's Ischemic,Contractures, Ischemic,Contractures, Volkmann,Ischemic Contracture, Volkmann's,Ischemic Contractures,Volkmann Contractures,Volkmann Ischemic Contracture,Volkmanns Ischemic Contracture
D019651 Plastic Surgery Procedures Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures. Cosmetic Reconstructive Surgical Procedures,Cosmetic Surgical Procedures,Esthetic Reconstructive Surgical Procedures,Esthetic Surgical Procedures,Plastic Surgical Procedures,Reconstructive Surgical Procedures,Reconstructive Surgical Procedures, Cosmetic,Cosmetic Reconstructive Surgery,Procedure, Reconstructive Surgical,Procedures, Reconstructive Surgical,Reconstructive Surgical Procedure,Reconstructive Surgical Procedures, Esthetic,Surgical Procedure, Reconstructive,Surgical Procedures, Reconstructive,Cosmetic Reconstructive Surgeries,Cosmetic Surgical Procedure,Esthetic Surgical Procedure,Plastic Surgery Procedure,Plastic Surgical Procedure,Procedure, Cosmetic Surgical,Procedure, Esthetic Surgical,Procedure, Plastic Surgery,Procedure, Plastic Surgical,Procedures, Cosmetic Surgical,Procedures, Esthetic Surgical,Procedures, Plastic Surgery,Procedures, Plastic Surgical,Reconstructive Surgeries, Cosmetic,Reconstructive Surgery, Cosmetic,Surgeries, Cosmetic Reconstructive,Surgery Procedure, Plastic,Surgery Procedures, Plastic,Surgery, Cosmetic Reconstructive,Surgical Procedure, Cosmetic,Surgical Procedure, Esthetic,Surgical Procedure, Plastic,Surgical Procedures, Cosmetic,Surgical Procedures, Esthetic,Surgical Procedures, Plastic
D064171 Superficial Back Muscles The top layer of the back muscles whose function is to move the SCAPULA. This group of muscles consists of the trapezius, latissimus dorsi, rhomboid major, rhomboid minor and levator scapulae. Latissimus Dorsi,Levator Scapulae,Rhomboid Major,Rhomboid Minor,Trapezius,Trapezius Muscle,Back Muscle, Superficial,Back Muscles, Superficial,Dorsi, Latissimus,Dorsus, Latissimus,Latissimus Dorsus,Muscle, Superficial Back,Muscle, Trapezius,Muscles, Superficial Back,Muscles, Trapezius,Rhomboid Majors,Rhomboid Minors,Scapulae, Levator,Superficial Back Muscle,Trapezius Muscles
D064827 Myocutaneous Flap A mass of tissue, including skin and muscle, that has been cut away from surrounding areas for transplantation. Musculocutaneous Flap,Flap, Musculocutaneous,Flap, Myocutaneous,Flaps, Musculocutaneous,Flaps, Myocutaneous,Musculocutaneous Flaps,Myocutaneous Flaps

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