RETRACTED: Amniotic Band Syndrome With Pseudoarthrosis of Tibia and Fibula: A Case Report

Abstract

Constriction of the lower limb by a congenital amniotic band has been proposed to explain the development of pseudoarthrosis of the tibia and fibula. We report a case of amniotic band syndrome in a preterm female infant with pseudoarthrosis of the tibia and fibula. She was born at 29 weeks of gestation with congenital amniotic bands and was noted to have a severely edematous left foot distal to the constricting band with rudimentary digits. The skin was pink and well perfused with palpable pulses. Radiography demonstrated pseudoarthrosis of the tibia and fibula. The limb deformities were managed with splints, positioning, and physiotherapy. She underwent Z-plasty with soft tissue release on the left lower leg on day 7 of life. At 36 weeks of postmenstrual age, a repeat radiograph showed markedly improved growth of the tibia and fibula with mature new bone formation, which avoided the need for further surgical intervention. During the follow-up period, she underwent left Syme's amputation at 18 months. At 29 months of age, the child was able to walk and run without support. The findings from our case confirm the potential for bone growth in patients with amniotic band syndrome, once the constricting band has been released. Simple release of the constriction band with Z-plasty resulted in growth of mature bone, replacing the pseudoarthrosis and, hence, the patient did not require surgical amputation. Thus, one should be cautious when deciding on surgical amputation, even in the presence of pseudoarthrosis, especially in preterm infants. Early limb-preserving surgery with release of the constricting band with an intention to salvage the limb appears appropriate.

Strangling Congenital Constriction Ring Band of the Forearm with Fracture: A Rare Case Report

“…Only a few cases of limb defects have been reported and most of them concern pseudarthrosis of the tibia and fibula [2-8]. Most of these cases have been treated with debridement, decortication, and immobilization.…”

“…One was treated with fasciectomy, nerve release, and pin fixation and another one was treated with external fixation and debridement [3,6]. All these articles have reported bone healing and good functional outcome [2-8].…”

A Rare Presentation of Amniotic band syndrome: Antenatal diagnosis and perinatal management

“…However, if there are membranes but they do not bind any organ, the pregnancy is mostly allowed to continue until maturity along with providing mother's mental care because the mothers will have high anxiety, which will result in stress in the fetus as well. After the fetus is born, the treatment will be then performed, such as by wearing special shoes or doing surgery to adjust the structure of the feet [14].…”

Amniotic Band Syndrome: A Silent Knife In-Utero

“…6 There is a potential for bone growth and functional limb preservation was reported in 50% of cases with fetoscopic amniotic band release, 71% with most of the interventions performed with laser dissection and 14% with endoscopic scissors. 28,30 If the release of the amniotic Patients should be fully informed about the risks and benefits. Potential complications, like postoperative subchorionic bleeding and membrane separation with amniotic fluid loss can result within the first 24 hours after surgery.…”