Monday, January 11, 2016

More on Amniotic Constriction Band

I have posted several time previously on Amniotic Constriction Band as can be found HERE.  There is also reasonable information on the web as can be found at Wikipedia and NORD and HERE. However, I do believe that it is helpful to share case examples.

Here is a 6 month old with Amniotic Constriction Band that was urgently treated for a tight thumb band and then sent to us for further assessment.  Pregnancy was uneventful and ultrasound did not identify the anomaly.  I want to emphasize again that this is really not a syndrome (which implies other findings) but is a diagnosis on its own.  It can effect any extremity or really any part of the body.  The right hand is more severely effected.  The thumb was treated emergently at another hospital due to a concern about survival.  This is a rare but real concern- the constriction band can be tight enough to cut off circulation.  There is a great pinky finger but the other digits are limited and there is the large excess tissue on the ring finger.  The left hand is less severely involved with a band on the index finger and a short middle finger.

Right hand with amniotic constriction band.  

Right hand with amniotic constriction band.  

Left hand with amniotic constriction band.  

This patient was taken to the operating room to remove the band on the left index finger and address the thumb on the right.  In addition, we removed the large bulbous tissue on the right ring finger.
Right thumb after reconstruction for amniotic constriction band.  Sutures are still dissolving.


Right ring finger after mass excision in amniotic constriction band.



Left index finger after reconstruction for amniotic constriction band.
This patient should do wonderfully from both an appearance and functional perspective.  The skin will continue to remodel.  The digits are sufficient for most functional activity.


Charles A. Goldfarb, MD
My Bio at Washington University
congenitalhand@wudosis.wustl.edu

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