PubMed · 12932268
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D C Russi, A D Irvine, A S Paller. 2003. Raised limb bands developing in infancy.. https://doi.org/10.1046/j.1365-2133.2003.05460.x
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OBJECTIVE: The objective of the study was to reproduce severe forms of extremity amniotic bands, which result in amputation or severe lesions. STUDY DESIGN: Right limbs of 5 60-day gestational age pregnant sheep were ligated with silk suture at the infracondylar level. Left limbs were used for paired comparison. The limbs obtained from term fetuses were analyzed morphologically, radiologically, and histologically. RESULTS: The ligated limbs showed an amputation or quasiamputation. Four extremities showed a necrotic pattern and 4 an edema pattern. CONCLUSION: A model of severe extremity amniotic bands that reproduces the effect of the extremity amniotic bands in the human fetus was developed. Future applications of this new model could be an experimental study of in utero salvage of limbs affected with severe extremity amniotic bands in the ovine fetus.
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A child presented at birth with a threatened lower limb from severe constriction band. Limb salvage was performed by emergency z-plasty reconstructions and subsequent sural nerve grafting to a fibrotic segmental deficit in the sciatic nerve. Follow-up over a 6-year period enables us to provide a favorable outlook with regard to functional use of the extremity and absence of chronic lymphedema, but she does have a significant limb length discrepancy. There is virtually no information on long-term functional outcome of such cases, although textbook teaching advises one to attempt emergency salvage of an extremity that is threatened by a severely constricting congenital amniotic band. Follow-up of our patient equips us with outcome information so that we can now better inform parents when once again faced with this problem in the neonate.