Abstract
IntroductionThe congenital constriction ring of lower extremity is very uncommon and rare condition. The actual incidence in general population is not known. In English literature, very few cases are reported time to time as congenital constriction band syndrome associated with musculoskeletal disorder like congenital talipes equino varus. The lesion can involve skin only or goes to deeper structure up to bone, which can lead to gangrene of foot or auto amputation.Case presentationWe are presenting a case of bilateral congenital constriction ring in lower limb who presented at age of 4 year without any other associated congenital anomaly, simply managed by Z-plasty, which improves quality of life after physiotherapy.ConclusionCongenital constriction ring of lower limb is extremely rare condition in children. Early diagnosis and management is mandatory, either in single stage or by stage procedure, to prevent auto-amputation of limb and to improve quality of life on feet.
Highlights
The congenital constriction ring of lower extremity is very uncommon and rare condition
Amniotic band syndrome is a sporadic condition that may result in constriction bands, amputation and multiple craniofacial, visceral and body wall defects
The incidence of congenital constriction bands of the extremities of childhood age in the general population is not known, but judging from the number of cases reported in the literature, the condition can be considered to be quite uncommon
Summary
The incidence of this condition in newborn is 0.1% [1]. The condition has different terminology in literature like Streeter dysplasia, amniotic bands, annular defects and anomalous bands that encircle, either partially or completely a digit or an extremity [2]. Other musculoskeletal disorders that may be present are clubfoot, synacdactly or acrosynacdactly, hypoplastic nails, hypoplastic fingers, pseudoarthrosis of underlying bones, absence of bones, peripheral nerve defects, distal lymphedema, intrauterine amputations, cleft lip and cleft palate and umbilical hernia [4]. Exact etiology of this syndrome is not known [5] but it may be caused by prenatal environmental factors and it appears to be result of excessive contraction of the uterine muscles and hemorrhages from marginal blood sinus [6]. Roentgenogram of lower extremity revealed marked soft tissue constriction ring present in both limb without any bony abnormality (Figure 2).
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