Constriction Band Research Articles

A Rare Case Report of Constriction Band Syndrome at the Wrist in a Child (Dhaga Syndrome)

ABSTRACT There are instances when elastic/thread bands are worn on the wrist, especially in infants or children in certain communities for either decorative or religious purposes. In case, it is worn for a long time, it burrows through the skin and soft tissues while going completely un-noticed, causing constriction and resulting in distal edema and loco-regional infection. The rare case discussed here is of a 3 years old female child who presented with circumferential constriction, swelling, and discharging sinuses around the right wrist for 7 months. The case was diagnosed on MRI and subsequently successfully managed surgically. The clinico-radiologic features and details of the case are discussed herein.

Early diagnosis of Voh Winkel syndrome-inherited honeycombed hands and hearing loss

Voh-Winkel Syndrome with approximately 50 cases reported in literature is a rare inherited Palmoplantar keratoderma characterised by honeycomb like hyperkeratosis, hearing loss or ichthyosis. It also features constricting fibrous bands that develop at the base of fingers/toes and later get strangulated to cause autoamputation called pseudoainhum. It is an autosomal dominant disorder with mutations in loricrin and connexin genes leading to hearing loss and ichthyosis variants respectively and manifests in infancy and becomes apparent later in childhood or adult life. Early diagnosis of this condition and management by multiple specialities given the associated features therefore becomes an absolute necessity. An emphasis on dermatological examination to manage hyperkeratosis using topical and systemic therapy, otorhinolaryngology to manage hearing loss as well as plastic surgery to alleviate symptoms arising due to the constriction bands is mandatory for effective management of this condition. Here we report a 22-year-old female patient who came with Palmoplantar keratoderma, bilateral hearing loss and pseudo-ainhum.

Case Report: Halting terminal osseous overgrowth post tibia amputation in children: a report of three cases

Terminal osseous overgrowth is a common complication after trans-diaphyseal amputation in children, leading to pain, soft tissue problems, and recurrent surgical procedures. We report three different cases with post-amputation issues of osseous overgrowth, ulceration, and deformity over the amputation site. The first case involves a 9-year-old boy with a right leg congenital amputation secondary to amniotic band syndrome. The right below-knee stump later experienced recurrent episodes of osseous overgrowth, leading to ulceration. After the prominent tibia was resected and capped with the ipsilateral proximal fibula, a positive outcome was achieved with no more recurrent overgrowth over the right leg stump. The second case involves a 9-year-old girl born with an amniotic constriction band over both legs. Her left leg remained functional after a circumferential Z-plasty, but the right leg was a congenital below-knee amputation. Multiple refashioning surgeries were performed on the right leg due to osseous overgrowth but the patient continued to experience recurrent overgrowth causing pain and difficulty fitting into a prosthesis. We performed osteocartilaginous transfer of the proximal part of the ipsilateral fibula to the right tibial end, successfully preventing the overgrowth of the tibia without any complications. The third case involves an 11-year-old boy with a history of meningococcal septicemia who underwent a right below-knee amputation and left ankle disarticulation due to complications of septic emboli. He experienced a prominent right distal tibia stump, which later developed into valgus deformity as a result of the previous insult to the proximal tibial growth plate. We performed a corrective osteotomy over the proximal right tibia and capped the entire tibia with the ipsilateral fibula as an intramedullary splint for the osteotomy site. Post-operatively, we achieved satisfactory deformity correction and successfully halted the recurrent overgrowth over the right tibia stump. The method of ipsilateral fibula capping is safe and effective in managing the osseous overgrowth complications in trans-diaphyseal amputations among children. Therefore, it is a reasonable option during primary below-knee amputations in children compared to multiple refashioning surgeries.

Trends, safety, and efficacy of wearable male sexual devices.

The prevalence of male sexual dysfunction (MSD) increases with age, with >50% of men aged >40years reporting erectile dysfunction (ED). In recent years, wearable male sex devices (WMSDs) have been increasingly utilized by patients and recommended by sexual medicine clinicians. This study seeks to investigate the safety and efficacy of products currently marketed for the treatment of MSD. Available products for WMSDs were reviewed by analyzing product websites, forums, advertisements, and clinical recommendations. Qualitative comparisons were based on patient reviews, cost, and specific features. Investigatory evidence and Food and Drug Administration status were also reviewed. Additionally, Google Trends was used to determine the popularity of devices over time. Eight WMSDs for the treatment of MSD and enhancement of sexual pleasure were reviewed. Constriction bands, such as the Maintain Ring Loop, Eddie by Giddy, and Xialla, have shown significant benefits in clinical trials and were the most popular devices among patients. Smart devices can provide real-time feedback on erectile quality and/or sexual performance. Similar to the RigiScan, the Adam sensor provides feedback on erectile quality while monitoring changes in penile tumescence during sleep with additional analysis available through a mobile application. Neuromodulation devices such as the Morari Patch and vPatch/in2 Patch use electrical stimulation to delay ejaculation and improve sexual function. The FirmTech Performance Ring uses sensors to track the vital signs of erectile fitness with clinical trials ongoing. Overall, this review describes the available investigatory evidence for a range of WMSDs and highlights the potential benefits and limitations of these devices in treating MSD and enhancing sexual pleasure. Further research is needed to evaluate the effectiveness of these devices and to determine which ones may be the most suitable for individual patients.

Collodion Baby Progressing to Camisa Syndrome: Case Report and Review of Literature in Asian Population

Palmoplantar keratoderma (PPK) is a broad entity comprising wide range of hereditary and acquired disorders. Herein, we present a case of 18-year-old female who presented with complaints of palmoplantar thickening since birth and progressive constriction bands around digits for 3 years. On examination, diffuse transgradient honeycomb type of PPK was present. Fibrous constriction bands (pseudoainhum) were present circumferentially around the distal interphalangeal joint of fifth finger and metatarsophalangeal joint of fifth toe bilaterally. Punch biopsy from palms revealed hyperkeratotic, stratified squamous epithelium with vacuolar degeneration and prominent keratohyaline granules. Audiogram was normal. On the basis of history, clinical examination and investigations, a diagnosis of Camisa syndrome was made and the patient was started on oral retinoids. We also discussed case findings of Camisa Syndrome reported in Asian population.

A novel surgical correction using a combination of wave-like incision and Z-axis Z-plasty for congenital constriction band syndrome

BackgroundA congenital constriction band (CCB) is a relatively common anomaly among limb malformations. However, the number of cases treated at a given center is limited and differences in techniques used by surgeons at each facility have a significant impact on the treatment outcomes. Several surgical methods have been reported, but a standard technique that yields consistent satisfactory results is still needed. Here, we introduce a novel technique for the treatment of CCB syndrome that uses a combination of wave-like skin incision and Z-axis Z-plasty. Patients and methodsA wave-like incision was used for skin incision with the goals of achieving an accordion effect and a less noticeable post-operative scar. After the fibrous constriction band was completely excised, a Z-plasty of sufficient size in the Z-axis direction was performed on the dermis-inclusive adipose tissue. For over 10 years, this technique was applied to 11 sites in 6 patients. A retrospective study of the characteristics of these cases was performed, including age at surgery, gender, type of deformity, degree of constriction, types of examination, number of surgeries, and post-operative outcomes. ResultsIn all patients, a normal contour of the limbs was achieved and the hourglass-like deformity caused by the constriction band was satisfactorily improved. No additional corrective surgeries were needed, there was no abnormal growth of the treated limbs, and scarring was aesthetically acceptable in all cases. ConclusionThe novel technique described here uses deep subcutaneous fat to correct the hourglass-like deformity and restores a normal limb contour, while the wave-like skin incision minimizes post-operative scarring.

New geographical and taxonomical observations on two rare Gonatozygon species (Zygnematophyceae, Desmidiales) from the upper Okavango Delta, Botswana

Two extremely rare and morphologically similar Gonatozygon species, namely G. dicranoaculeatum and G. chadefaudii, were previously recorded from only two geographical locations in the world. G. dicranoaculeatum was reported from Zambia and Australian billabongs, while G. chadefaudii was known from French Guiana and Australian billabongs. During June 2023, a Gonatozygon species was discovered in the upper reaches of the Okavango Delta, Botswana. This species had characteristics corresponding to both G. dicranoaculeatum and G. chadefaudii and can, therefore, be regarded as an intermediate between these two species. The main distinguishing characteristics between G. dicranoaculeatum and G. chadefaudii include the structure of the apices and chloroplasts, the presence of girdle bands and a slight median constriction, the cell length-to-width ratio, and the length of the spines on the surface. Gonatozygon cells from the Okavango Delta corresponded to G. dicranoaculeatum with regards to the chloroplast structure and the absence of a median constriction and girdle bands but were closer to G. chadefaudii in terms of their dilated apices and dimensions. Due to the discovery of cells with intermediate characteristics, the authors propose the merger of G. dicranoaculeatum and G. chadefaudii into a single taxon, namely G. dicranoaculeatum, as this name has priority. G. chadefaudii should then be transferred to a synonym of G. dicranoaculeatum.

(251) Exploring Trends, Safety, and Efficacy of Wearable Male Sexual Devices: Revolutionizing Intimacy

Abstract Introduction The prevalence of male sexual dysfunction (MSD) increases with age, with greater than 50% of men aged over 40 years reporting erectile dysfunction (ED). In recent years, wearable male sex devices (WMSDs) have been both increasingly utilized by patients and recommended by sexual medicine clinicians. Objective This study seeks to investigate the safety and efficacy of products currently marketed for the treatment of MSD. Methods Available products for WMSDs were reviewed by analyzing product websites, forums, advertisements, and clinical recommendations. Qualitative comparisons were made based on patient reviews, cost, and specific features of each device. Investigatory evidence and FDA status were also reviewed (Figure 1). Additionally, Google Trends was used to determine the popularity of different devices over time (Figure 2). Results Eight WMSDs for the treatment of MSD and enhancement of sexual pleasure were reviewed. Constriction bands, such as the Maintain Ring Loop, Eddie by Giddy, and Xialla, have shown significant benefits in clinical trials and were found to be the most popular devices among patients. Smart devices can provide real-time feedback on erectile quality and/or sexual performance. Similar to the Rigiscan, the ADAM sensor provides feedback on erectile quality while also monitoring changes in penile tumescence during sleep with additional analysis available through a mobile application. Neuromodulation devices like Morari Patch and vPatch/in2 patch use electrical stimulation to delay ejaculation and improve sexual function. The FirmTech Performance Ring uses sensors to track the vital signs of erectile fitness with clinical trials ongoing. Conclusions Overall, this review describes the available investigatory evidence for a range of WMSDs and highlights the potential benefits and limitations of these devices in treating MSD and enhancing sexual pleasure. Further research is needed to evaluate the effectiveness of these devices and to determine which ones may be the most suitable for individual patients. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Charles A Loeb, MD - None relevant Muhammad A M Hammad, MBBCh - None relevant David W Barham, MD - None relevant Jake Miller MD - None relevant Kirsten Young, MS - None relevant Rainey Horwitz, MD – Paid collaboration with FirmTech on Instagram Eliad Amini, BS - None relevant Mai Xuan Nguyen, BS - None relevant Nitish Nag, MD, PhD - None relevant Lawrence Jenkins, MD – None relevant Amy M Pearlman, MD – Consultant for/received grant funding from Boston Scientific; consultant for Endo Pharmaceuticals; consultant for FirmTech; investor in ByteMD; influencer in Urology Times Faysal A Yafi, MD – Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.

(354) Revolutionizing Intimacy: Exploring Trends, Safety, and Efficacy of Wearable Male Sexual Devices

Abstract Introduction The prevalence of male sexual dysfunction (MSD) increases with age, with greater than 50% of men aged over 40 years reporting erectile dysfunction (ED). In recent years, wearable male sex devices (WMSDs) have been both increasingly utilized by patients and recommended by sexual medicine clinicians. Objective This study seeks to investigate the safety and efficacy of products currently marketed for the treatment of MSD. Methods Available products for WMSDs were reviewed by analyzing product websites, forums, advertisements, and clinical recommendations. Qualitative comparisons were made based on patient reviews, cost, and specific features of each device. Investigatory evidence and FDA status were also reviewed (Figure 1). Additionally, Google Trends was used to determine the popularity of different devices over time (Figure 2). Results Eight WMSDs for the treatment of MSD and enhancement of sexual pleasure were reviewed. Constriction bands, such as the Maintain Ring Loop, Eddie by Giddy, and Xialla, have shown significant benefits in clinical trials and were found to be the most popular devices among patients. Smart devices can provide real-time feedback on erectile quality and/or sexual performance. Similar to the Rigiscan, the ADAM sensor provides feedback on erectile quality while also monitoring changes in penile tumescence during sleep with additional analysis available through a mobile application. Neuromodulation devices like Morari Patch and vPatch / in2 patch use electrical stimulation to delay ejaculation and improve sexual function. The FirmTech Performance Ring uses sensors to track the vital signs of erectile fitness with clinical trials ongoing. Conclusions Overall, this review describes the available investigatory evidence for a range of WMSDs, and highlights the potential benefits and limitations of these devices in treating MSD and enhancing sexual pleasure. Further research is needed to evaluate the effectiveness of these devices and to determine which ones may be the most suitable for individual patients. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Charles A Loeb, MD - None relevant Muhammad A M Hammad, MBBCh - None relevant David W Barham, MD - None relevant Jake Miller MD - None relevant Kirsten Young, MS - None relevant Rainey Horwitz, MD – Paid collaboration with FirmTech on Instagram Eliad Amini, BS - None relevant Mai Xuan Nguyen, BS - None relevant Nitish Nag, MD, PhD - None relevant Lawrence Jenkins, MD – None relevant Amy M Pearlman, MD – Consultant for/received grant funding from Boston Scientific; consultant for Endo Pharmaceuticals; consultant for FirmTech; investor in ByteMD; influencer in Urology Times Faysal A Yafi, MD – Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.

Neuromuscular Dysfunction in Clubfeet Associated With Constriction Band Syndrome.

Constriction band syndrome (CBS) is a congenital limb anomaly frequently associated with clubfoot. Clubfeet in CBS patients may be associated with peroneal nerve dysfunction in the involved lower extremity; however, the etiology of this neuromuscular dysfunction is not clear. We sought to characterize the distribution of constriction bands on lower extremities with clubfoot and determine if neuromuscular deficit (NMD), defined here as having absent ankle dorsiflexion, was associated with ipsilateral proximal bands. Our secondary aim was to compare the treatment and outcomes of clubfeet with NMD to those without NMD. We performed a retrospective review of all patients with CBS and clubfoot presenting to our facility between January 1, 1998 and December 31, 2018. Treatment with the Ponseti method, at least 1 year of follow-up at this facility, and a detailed physical exam describing lower extremity neuromuscular function and the presence and location of constriction bands were required for inclusion in the study cohort. Twenty children with 26 clubfeet were included. Forty-six percent (12/26) of the clubfeet had NMD. Clubfeet with and without NMD had ipsilateral thigh or leg constriction bands at similar rates [42% (5/12) vs. 43% (6/14), P =0.106], and the majority (7/12) of clubfeet with NMD did not have an ipsilateral thigh or leg band. While children with an NMD clubfoot tended toward more casts, relapses, and surgical procedures, these differences did not reach statistical significance. The use of a daytime AFO beyond age four was higher in the NMD clubfeet [58% (7/12) vs. 14% (2/14), P =0.04]. Clubfeet with neuromuscular deficits may occur in the absence of proximal ipsilateral constriction bands, suggesting they may be caused by mechanisms other than direct damage from visible constriction bands to underlying nerves. They can also coexist with arthrogrypotic conditions. Clubfeet with an NMD tended toward more casts, relapses, and surgeries than those without NMD, but these differences did not reach statistical significance. These patients often elect long-term use of a daytime AFO.

Amniotic Band Syndrome: Head-to-Toe Manifestations and Clinical Management Guidelines.

After studying this article, the participant should be able to: 1. Understand and describe the basic principles underlying the intrinsic versus extrinsic proposed mechanisms for the development of amniotic band syndrome (ABS). 2. Discuss risk factors and conditions that are associated with the development of ABS. 3. Understand the various presentations and associated clinical implications of ABS by anatomic location. 4. Describe the basic tenets underlying various repair technique options for ABS of the extremities. 5. Discuss the common manifestations of ABS in the face and trunk. 6. Understand clinical implications of fetoscopic surgery as it relates to ABS treatment as a novel method for limb salvage in utero. Amniotic band syndrome (ABS) refers to the development of constrictive bands of fibrotic tissue in utero. It can lead to a variety of clinical manifestations after delivery. There is much debate in the plastic surgery community regarding the exact pathophysiologic mechanism for the development of ABS, and the most appropriate management. This CME article aims to provide an overview of ABS manifestations throughout the body, and to expound on the most recent advances in anticipatory and definitive management of the condition.

Jednoaktna procedura po Mutafu za urođene konstriktivne prstenove - bezbedna i efikasna

Introduction: Congenital constriction ring is a rare congenital malformation that especially affects the limbs. It is associated with fibrous bands that could encircle, strangle, or amputate some parts of the fetus. However, there are only a few techniques described for the correction of this anomaly. We aim to present a successful treatment of congenital constriction ring by means of the one-stage Mutaf technique. Patient Review: In our report, we presented two infants with congenital constriction rings. In the first case, we presented an infant with a constriction band on the right arm accompanied by deformity of the distal part and lymphoedema. In the second case, we presented an infant with multiple constriction bands on the distal part of the right leg with clubfeet and severe lymphoedema. They were both treated by the one-stage Mutaf technique using rectangular dermofat grafts to fill the groove. Using this technique we obtained a normal limb contour, with no oedema or neurovascular compromise. Filling the groove with the rectangular dermofat flaps parallel to the relaxed skin tension lines provides a better scar in comparison with multiple Zor W-plastics techniques. Additionally, advantages of the one-stage procedure are reduction of surgical and psychological trauma in patients and their parents, less time spent under general anesthesia and lower amount of anesthetic the patient receives, and lower treatment costs. Conclusion: We find the Mutaf technique to be an effective and safe technique for the treatment of congenital constriction rings.

Management of Congenital Melanocytic Naevus (CMN) of the Lower Pole of the Breast Causing Secondary Tuberous Breast Deformity (TBD)- A Case Report and Review of Literature: Congenital Melanocytic Naevus &Tuberous Breast Deformity

A 19-year-old woman was referred with a congenital melanocytic naevus (CMN) involving the lower pole of her right breast, combined with features of tuberous breast deformity (TBD) and breast asymmetry. Staged correction of the breast asymmetry was planned. The first stage involved recruitment of her right upper abdominal skin, in a reverse abdominoplasty manner, to address the lower pole skin deficiency. Extensive radial release of the constriction bands across the original IMF (inframammary fold), and circum-areolar mastopexy were performed. A sub-glandular breast implant was inserted. Four weeks later, she presented with minor inframammary wound breakdown. Washout and removal of the implant, combined with breast parenchymal tissue rearrangement was performed. We performed her planned second stage 3 months later in the form of; a right vertical pattern mastopexy, lipofilling and revision of the reverse abdominoplasty to adjust the nipple and IMF position. The remaining CMN was excised and resurfaced with a full thickness skin graft from the contralateral mastopexy. The leathery quality of CMN makes the achievement of correcting the breast deformity impossible without its excision. This combination of CMN and TBD makes management of these cases more challenging than manging each on its own. To the best of our knowledge, this is the first case report of the effect of moderate CMN on the breast and its development.

The Dhaga Syndrome: An Important Differential of Acquired Constriction Band around the Wrist in India

Rubber band syndrome aka Dhaga syndrome is a rare entity mostly seen in young population in communities where rubber bands/mauli dhaga are worn over the wrist for decorative or religious purposes. If the band is worn for long duration, then it produces constrictive features burrowing through the skin and subcutaneous tissue.

Prevalence of vascular disruption anomalies and association with young maternal age: A EUROCAT study to compare the United Kingdom with other European countries.

Younger mothers are at a greater risk of having a pregnancy with gastroschisis and the risk is higher in the United Kingdom than other European countries. Gastroschisis is thought to be a vascular disruption anomaly and the aim of this study was to analyze the prevalence of other possible vascular disruption anomalies to determine whether both the younger maternal age and the UK associations also occur with these anomalies. All pregnancies with anomalies considered potentially due to vascular disruption from January 1, 2005 to December 31, 2017 from 26 European population-based congenital anomaly registries who were members of EUROCAT were analyzed. Multilevel models were used to allow for differences between registries when analyzing associations with maternal age, year of birth and whether the registry was in the United Kingdom. There were 5,220 cases with potential vascular disruption anomalies, excluding chromosomal and genetic conditions, with a prevalence of 8.85 per 10,000 births in the United Kingdom and 5.44 in the other European countries. The prevalence per 10,000 births of gastroschisis (4.45 vs. 1.56) and congenital constriction bands (0.83 vs. 0.42) was significantly higher in the United Kingdom, even after adjusting for maternal age. However, transverse limb reduction defects had a similar prevalence (2.16 vs. 2.14 per 10,000). The expected increased prevalence in younger mothers was observed for vascular disruption anomalies overall and for the individual anomalies: gastroschisis and congenital constriction bands. Vascular disruption anomalies that had an increased risk for younger mothers (such as gastroschisis) had a higher maternal age standardized prevalence in the United Kingdom, while vascular disruption anomalies with weaker associations with younger mothers (such as transverse limb reduction defects) did not have an increased prevalence in the United Kingdom, which may indicate a different etiology for these anomalies.

An Uncommon Presentation of Constriction Band Syndrome: A Case Report and Review of Literature

One of the rarer manifestations of constriction band syndrome (CBS) is peripheral nerve palsy. We report a 6-year-old child presenting with motor deficits of the median, ulnar and radial nerves and atrophy of the biceps and brachialis atrophy due to CBS. We were unable to find any similar reports in the literature. He had a constriction ring at the upper arm that had undergone multiple z-plasty by another surgeon. On examination, he had medical research council (MRC) grade 1 elbow flexion, weak flexion of fingers and absent extension of fingers and wrist. We used a pedicled pectoralis major myocutaneous flap to restore elbow flexion and the patient achieved M4 flexion of the elbow. Level of Evidence: Level V (Therapeutic).

Food cue reactivity in successful laparoscopic gastric banding: A sham-deflation-controlled pilot study.

Laparoscopic adjustable gastric banding (LAGB) offers a unique opportunity to examine the underlying neuronal mechanisms of surgically assisted weight loss due to its instant, non-invasive, adjustable nature. Six participants with stable excess weight loss (%EWL ≥ 45) completed 2 days of fMRI scanning 1.5–5 years after LAGB surgery. In a within-subject randomized sham-controlled design, participants underwent (sham) removal of ∼ 50% of the band’s fluid. Compared to sham-deflation (i.e., normal band constriction) of the band, in the deflation condition (i.e., decreasing restriction) participants showed significantly lower activation in the anterior (para)cingulate, angular gyrus, lateral occipital cortex, and frontal cortex in response to food images (p < 0.05, whole brain TFCE-based FWE corrected). Higher activation in the deflation condition was seen in the fusiform gyrus, inferior temporal gyrus, lingual gyrus, lateral occipital cortex. The findings of this within-subject randomized controlled pilot study suggest that constriction of the stomach through LAGB may indirectly alter brain activation in response to food cues. These neuronal changes may underlie changes in food craving and food preference that support sustained post-surgical weight-loss. Despite the small sample size, this is in agreement with and adds to the growing literature of post-bariatric surgery changes in behavior and control regions.

Treatment of an amniotic band syndrome with fetoscopic surgery: a case report

Objective: This study aimed to present an amniotic band syndrome case who underwent intrauterine fetoscopic surgery. Case(s): On ultrasound examination, edema was detected at the distal of the right upper extremity. The constrictive amniotic band tangling around the extremity at the upper part of the right elbow and around the umbilical cord was detected during the fetoscopic examination. The amniotic band was released by using endoscopic scissors and grasper. It was observed that the right hand was at the flexion position and was able to return to the neutral position on neonatal examination. Conclusion: Releasing amniotic band with fetoscopic surgery in amniotic band syndrome cases is an efficient method to prevent progressive destruction in the extremities and the procedure-related complications seem to be acceptable.

Acquired Constriction Band Syndrome Affecting Multiple Digits – A Case Report

Rubber band syndrome is a condition that usually affects children because of wearing a rubber band on the wrist or the ankle. Depending on the degree of pressure caused by the band, patients may present acutely with ischemia and necrosis of the tissues distal to the bands or chronically with change in shape, oedema, loss of function, sensation and rarely amputation. This condition is very rare in adults and most reports in literature are in patients with cognitive impairment or psychiatric illness. We report 62-year-old lady with a background of a psychiatric illness who presented with an acquired constriction band syndrome affecting multiple digits of both hands. Level of Evidence: Level V (Therapeutic).

Media Depiction of Birth Differences of the Upper Extremity: Accuracy of Shared Diagnoses.

To assess the diagnostic accuracy of public representation of congenital differences of the upper extremities. We hypothesized that there is an over-diagnosis of certain diagnoses such as amniotic constriction band and under-diagnosis of others such as symbrachydactyly and radial deficiency. Publicly shared images and associated diagnoses were searched on publicly available news media and social media accounts published from October 2018 through November 2021 using key terms such as "amniotic band syndrome," "congenital arm amputation," and "3D prosthetic arm" as well as The Lucky Fin Project account on Instagram. The images were collected and reviewed by 2 congenital hand surgeons. The surgeons' diagnoses were then compared to the reported diagnoses associated with each image to assess accuracy. A total of 100 images were collected with the reported diagnosis associated with each image. Two images were removed due to evidence of prior surgery. The hand surgeons' diagnosis disagreed with the reported diagnosis in 60 of 98 (61%) images. Of those 60 inaccurate diagnoses, 2/3 were reported as amniotic constriction band. Media and social media depictions of congenital upper extremity differences are frequently inaccurate, and our search demonstrated that the amniotic constriction band is the most commonly reported, inaccurate diagnosis. Accuracy of diagnosis in public media is important given the impact a diagnosis has on those viewing and sharing the images. Level IV, diagnostic.