Bautista Catherine H, Vitale Alexandra S, Chen Joanna, Ormiston Laurel, Collar Yagas Lucia, Johns Dana N
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
Plast Reconstr Surg Glob Open. 2024 Sep 18;12(9):e6181. doi: 10.1097/GOX.0000000000006181. eCollection 2024 Sep.
Constriction ring syndrome is a rare congenital condition characterized by the formation of fibrous amniotic bands, which can result in limb or digit deformation, malformation, or autoamputation. Surgical intervention is necessary for patients with progressive or severe forms of constriction banding, but the timing and operative approach vary widely. Here, the authors present a case report detailing the successful removal of multiple congenital constriction bands (CBs), uniquely affecting the distal ankle and foot in an infant meeting Patterson type-2 criteria. This type is characterized by CBs resulting in distal deformation with or without swelling. In this case, urgent intervention was prompted by concerns of vascular compromise, and amputation was considered due to the severity of the banding. However, the authors advocated for a staged approach, with the aim of preserving the patient's limb. A series of three separate procedures tailored to the patient's banding pattern and subsequent tissue complications were required to achieve restoration of ankle and foot functions, as well as satisfactory cosmesis. This case report underscores the importance of a customized surgical approach in addressing complex CBs and emphasizes the need for proactive consideration of salvage interventions by surgeons.
狭窄环综合征是一种罕见的先天性疾病，其特征是形成纤维性羊膜带，可导致肢体或手指变形、畸形或自截。对于进行性或严重形式的狭窄环扎患者，手术干预是必要的，但手术时机和手术方法差异很大。在此，作者报告一例病例，详细介绍了成功切除多条先天性狭窄环，该狭窄环独特地影响了一名符合帕特森2型标准婴儿的远端踝关节和足部。这种类型的特征是狭窄环导致远端变形，伴有或不伴有肿胀。在本病例中，由于担心血管受压而进行了紧急干预，并且由于环扎的严重程度而考虑进行截肢。然而，作者主张采用分阶段方法，目的是保留患者的肢体。为了恢复踝关节和足部功能以及达到满意的美容效果，需要根据患者的环扎模式和随后的组织并发症进行一系列三个单独的手术。本病例报告强调了定制手术方法在处理复杂狭窄环中的重要性，并强调外科医生需要积极考虑挽救性干预措施。
