Case ReportNo Access

An Uncommon Presentation of Constriction Band Syndrome: A Case Report and Review of Literature

All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

E-mail Address: drshilpikarmakar@rediffmail.com

Correspondence to: Dr. Shilpi Karmakar, Department of Burns and Plastic Surgery, OPD Building Room 402, Block A, All India Institute of Medical Sciences MIA 2nd Phase, Basni, Jodhpur, Rajasthan 342005, India. Tel:+91-96280-00023

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and

Brijesh MISHRA

King George’s Medical University, Lucknow, India

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https://doi.org/10.1142/S2424835522720419Cited by:0 (Source: Crossref)

Abstract

One of the rarer manifestations of constriction band syndrome (CBS) is peripheral nerve palsy. We report a 6-year-old child presenting with motor deficits of the median, ulnar and radial nerves and atrophy of the biceps and brachialis atrophy due to CBS. We were unable to find any similar reports in the literature. He had a constriction ring at the upper arm that had undergone multiple z-plasty by another surgeon. On examination, he had medical research council (MRC) grade 1 elbow flexion, weak flexion of fingers and absent extension of fingers and wrist. We used a pedicled pectoralis major myocutaneous flap to restore elbow flexion and the patient achieved M4 flexion of the elbow.

Level of Evidence: Level V (Therapeutic)

Keywords:

REFERENCES

1. Koskimies E, Syvanen J, Nietosvaara Y, Makitie O, Pakkasjarvi N. Congenital constriction band syndrome with limb defects. J Pediatr Orthop. 2015;35:100–103. https://doi.org/10.1097/BPO.0000000000000206. Crossref, Google Scholar
2. Weinzweig N, Barr A. Radial, ulnar, and median nerve palsies caused by a congenital constriction band of the arm: Single-stage correction. Plast Reconstr Surg. 1994;4:872–876. https://doi.org/10.1097/00006534-199411000-00022. Crossref, Google Scholar
3. Tada K, Yonenobu K, Swanson AB. Congenital constriction band syndrome. J Pediatr Orthop. 1984;4:726–773. https://doi.org/10.1097/01241398-198411000-00013. Crossref, Google Scholar
4. Foulkes GD, Reinker K. Congenital constriction band syndrome: A seventy-year experience. J Pediatr Orthop. 1994;14:242. https://doi.org/10.1097/01241398-199403000-00021. Crossref, Google Scholar
5. Richardson GA, Humphrey MS. Congenital compression of the radial nerve. J Hand Surg. 1989;14:901–903. https://doi.org/10.1016/s0363-5023(89)80099-1. Crossref, Google Scholar
6. Jones NF, Smith AD, Hedrick MH. Congenital constriction band syndrome causing ulnar nerve palsy: Early diagnosis and surgical release with long term follow-up. J Hand Surg. 2001;26:467–473. https://doi.org/10.1053/jhsu.2001.24130. Crossref, Google Scholar
7. Rapp SJ, Pan BS, Yakuboff KP. Flail extremity resulting from constriction band syndrome: Neurovascular implications and surgical management. Cas Rep Plast Surg Hand Surg. 2014;1:29–32. https://doi.org/10.3109/23320885.2014.962538. Crossref, Google Scholar
8. Uchida Y, Sugioka Y. Peripheral nerve palsy associated with congenital constriction band syndrome. J Hand Surg. 1991;16:109. https://doi.org/10.1016/0266-7681(91)90144-d. Crossref, Google Scholar
9. Beidas O, Rayan GH, Al-Harthy A. Digital sucking induced trophic ulcers caused by nerve deficit from amniotic constriction band. J Plast Reconstr Aesth Surg. 2010;63:e631–e634. March 29, 2010. https://doi.org/10.1016/j.bjps.2010.01.019. Crossref, Google Scholar
10. Weeks PM. Radial, median, and ulnar nerve dysfunction associated with a congenital constricting band of the arm. Plast Reconstr Surg. 1982;69:333–336. https://doi.org/10.1097/00006534-198202000-00027. Crossref, Google Scholar