Clubfeet and congenital constriction band syndrome.

BACKGROUND: Clubfeet and constriction band syndrome is a very rare non-idiopathic condition. Treatment is often difficult and the recurrence deformity rate is high. The purpose of this study was to assess the effectiveness of Ponseti method in the treatment of congenital constriction band syndrome accompanied by clubfoot deformity and lymphedema. CASE PRESENTATION: We are presenting an interesting case of bilateral clubfeet and congenital circumferential constriction band syndrome in the lower limb. Ponseti method of correcting the congenital clubfoot deformity was applied. Constriction band release is accomplished by two stages completely excising the fibrous band and multiple two-stage Z-plasties on the right calf. CONCLUSION: The results of this study indicate that the Ponseti method of gentle, systematic manipulation and weekly cast changes is an effective treatment of non-idiopathic clubfoot distal to congenital amniotic constriction band.

Tratamiento de las malformaciones en extremidades en el síndrome de bridas amnióticas: a propósito de un caso / Amniotic band syndrome: management of skeletal limb abnormalities. A case report

El síndrome de bridas amnióticas es un complejo de anomalías congénitas causadas por la rotura prematura del amnios, por lo que se originan bandas fibrosas que comprimen determinadas regiones del feto. Afecta a entre 1:1200 y 1:15 000 recién nacidos vivos según las series consultadas.La clínica típica consiste en alteraciones en las extremidades (anillos de constricción, amputaciones asimétricas más o menos distales, sindactilias y pie zambo), y se han descrito alteraciones toracoabdominales o faciales. Recientes trabajos han demostrado la utilidad del método de Ponseti en el tratamiento del pie zambo asociado al síndrome de bridas amnióticas. Se presenta el caso de un recién nacido que padecía un síndrome de bridas amnióticas y se ahonda en el manejo y la resolución quirúrgica de las malformaciones en las extremidades. En especial, se analiza la utilización del método de Ponseti en el tratamiento del pie zambo congénito sindrómic

Amniotic band syndrome consists in a group of congenital abnormalities caused by strands of the amniotic sac that entangle some parts of the fetus. Those strands result from premature rupture of amnios. The incidence of amniotic band syndrome is 1:1200 to 1:15,000 live births, depending on case studies.Mostly affected parts of fetus are limbs (asymmetric amputations, syndactyly and clubbed foot) but facial and thoracoabdominal abnormalities have also been described.Recent works have proved the utility of Ponseti method to treat clubfoot associated with amniotic band syndrome. We report the case of a newborn with amniotic band syndrome focusing on management and surgical repair of limbs deformities. Especially, we highlight the use of Ponseti method in treatment of syndromic clubfoot

Lipoinjection and Multiple Internal Cuts for Congenital Constriction Bands: A New Treatment Approach.

BACKGROUND: Traditional treatment for a congenital constriction band of the limb involves multiple Z-plasties and W-plasties. We propose an alternative surgical procedure for the treatment of congenital constriction bands that obviates the need for Z-plasties and eliminates the constriction band. METHODS: We present the case of a 36-year-old woman with a congenital constriction band of the leg. Using a minimally invasive approach, the skin segment that included the band was dissected from the deep tissues. Afterwards, multiple slices were performed on the internal surface of the fibrous ring. This and lipoinjection were used to reverse the depression that characterizes the "hourglass sign" and homogenize the skin surface. RESULTS: Results have remained stable in a follow-up period of 18 months. CONCLUSIONS: This surgical alternative can be considered as an option for the treatment of congenital constriction bands. It is a safe, reproducible procedure that does not cause additional scars and has good functional and aesthetic results. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Placento-Cranial Adhesions in Amniotic Band Syndrome and the Role of Surgery in Their Management: An Unusual Case Presentation and Systematic Literature Review.

Amniotic band syndrome is a group of sporadic congenital anomalies that involve the limbs, craniofacial regions and trunk, ranging from simple digital band constriction to complex craniofacial and central nervous system abnormalities. Placento-cranial adhesions in amniotic band syndrome are extremely rare, and severe conditions are associated with high morbidity and mortality rates. In this study, we pooled placento-cranial adhesion case reports that were published in the medical literature and added an unpublished case from our institution. The purpose of this article was to review and discuss the clinical features and outcomes of placento-cranial adhesions in amniotic band syndrome.

Amniotic band sequence--a debilitating syndrome.

A male baby was delivered by Caesarean section at term to a 35 years second gravida lady with fibroid uterus. The mother was booked and immunized and not on any medication. Antenatal and natal periods including serial ultrasounds were normal. At birth the neonate was observed to have multiple grooves over ring & middle index finger of left hand and hypoplasia of left little finger. Both great toes were amputated. In view of asymmetrical involvement, presence of amniotic bands, no other organ involvement and sporadic nature, he was diagnosed as a case of amniotic band sequence. Congenital amputations should be distinguished from congenital hypoplasia and/or aplasia. Differentiation is important for genetic counselling and evaluation of the risk of recurrence.

Lesiones anulares en neonato tras fototerapia / Annular Lesions Following Phototherapy in a Newborn Infant

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Intrauterine sling: a complication of the stuck twin syndrome.

Stuck twin syndrome usually presents with polyhydramnios in the recipient sac and severe oligohydramnios in the donor sac. The donor is displaced against the uterine wall and remains adherent in that position. We present a case in which the diagnosis was more complicated, owing to the suspension of the stuck twin by a sling within the sac of the recipient. A monochorionic diamnionic twin gestation was complicated by twin-twin transfusion syndrome at 18 weeks of gestation. In our example, the stuck twin was suspended by a sling from the placenta. The sling band represented the intertwin membrane that was folded upon itself. Amniotic fluid from the recipient twin was present in three dimensions around the stuck twin, except for the sling band. The suspension of the stuck twin by a sling within the amniotic fluid of the recipient is an unusual manifestation of the stuck twin syndrome.

Diagnóstico ultrasonográfico y manejo de la ectopia cordis / The ultrasonic diagnosis and management of ectopia cordis

Se denomina síndrome de hendidura esternal una serie de anomalías congénitas que van desde pequeños defectos del manubrio esternal hasta severos defectos de fusión. El más severo de estos defectos es la ectopia cordis, en el cual el corazón está fuera del tórax y generalmente se acompaña de otras malformaciones. El diagnóstico ultrasonográfico de ectopia cordis es facil y consiste en la demostración del corazón fuera de su localización. Se presenta un caso de ectopia cordis torácica, sin cardiopatías internas, acompañado de otras malformaciones, asociado a placenta con banda amniótica. Se hacen comentarios acerca del diagnóstico ecosonográfico y manejo de dicha patología