Amniotic constriction bands

Alternative names 
Pseudo-ainhum; Streeter’s dysplasia

Definition
Amniotic constriction bands are a congenital (present from birth) deformity of the limbs (arms or legs) or digits (fingers or toes) caused by a type of damage to the placenta which cuts off their blood supply and prevents normal development.

Causes, incidence, and risk factors
Damage to the amnion (part of the placenta) may produce fibrous bands that can entrap the limbs of the fetus. These bands compress the area of the limb over which they run, reducing blood supply and causing the limb to develop abnormally. This is a relatively rare disease.

Symptoms

     
  • a permanent band or indentation around an arm, leg, finger, or toe  
  • congenital amputation of all or part of an arm or leg  
  • abnormal gap in the face (called a cleft, if band was across face)  
  • abdominal or chest wall defect (if band located in those areas)

Signs and tests
Physical examination is sufficient to make this diagnosis.

Treatment
The severity of the deformity can vary widely from only one toe or finger being affected, to an entire arm or leg missing or being severely underdeveloped. Therefore, the treatment varies widely. Often, the deformity is not severe and there is no treatment needed. In more serious cases, major surgery may be needed to reconstruct all or part of an arm or leg.

Expectations (prognosis)
Again, the prognosis depends on the severity of the disease. Most cases are mild and the prognosis for normal function is excellent. More involved cases have more guarded prognoses.

Complications
Complications can include complete or partial loss of function of an arm or a leg. Congenital bands affecting the hand are the most problemtatic.

Calling your health care provider
This disease is usually diagnosed at birth.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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