Burns and Plastic Surgery, Manchester University NHS Foundation Trust, Manchester, UK
Burns and Plastic Surgery, Manchester University NHS Foundation Trust, Manchester, UK.
BMJ Case Rep. 2024 Mar 15;17(3):e258063. doi: 10.1136/bcr-2023-258063.
A neonate was born with a unique congenital lower limb dysmelia due to an abnormal presentation of amniotic band syndrome. An anomalous soft tissue tether from the plantar surface of the right foot to the right buttock caused extreme knee flexion, tibial rotation and malformation of the developing foot. This complex malformation required a multidisciplinary team (MDT) approach to decide between reconstruction and amputation. The band of tissue was released operatively at 73 days postdelivery, improving knee extension, and the tissue was banked on the thigh as a tube pedicle for future reconstruction. The patient underwent rehabilitation, which has been shown to be vital for synovial joint formation. At 18 months old, the decision was made to proceed with through-knee amputation and a prosthesis. The literature discussed shows the importance of an MDT approach in complex lower limb cases to give the best functional outcome for the patient.
一名新生儿因羊水带综合征的异常表现而出生时患有独特的先天性下肢畸形。从右脚足底到右臀部的异常软组织束带导致严重的膝关节屈曲、胫骨旋转和发育中足部畸形。这种复杂的畸形需要多学科团队 (MDT) 来决定是重建还是截肢。在出生后 73 天时,通过手术释放了束带组织,改善了膝关节伸展,将组织作为管状蒂存于大腿上,以备将来进行重建。患儿接受了康复治疗,这对滑膜关节形成至关重要。在 18 个月大时,决定进行膝关节下截肢和假肢安装。文献讨论表明,在复杂的下肢病例中,采用 MDT 方法对于为患者提供最佳的功能结果非常重要。