Congenital pressure necrosis of the forearm in a newborn infant

The authors report a case of congenital pressure necrosis of the forearm pr esenting in a newborn infant. The patient presented with an edematous and p urpuric upper extremity with no underlying vascular compromise. After demar cation of the nonviable tissue during the first month of life, the extremit y was debrided, and a thin split-thickness skin graft was applied, Graft co ntracture over the subsequent year was released and reconstructed with a fu ll-thickness skin graft. Patient follow-up at age 22 months demonstrated pr ogressive return of strength and function of the extremity with restoration of soft-tissue bulk and contour. When presented with this unusual circumst ance, the plastic surgeon should be familiar with its differential diagnosi s and management. Conservative debridement and age-appropriate resurfacing of the remaining wound were the essential treatment principles followed in this patient.