足と足首の臨床研究

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A Case Report of Active Amniotic Band Syndrome with Progressive Lymphedema Causing Vascular Insufficiency: Radical Excision of the Overgrown Tissue

Santiago Aleman, Bibiana Dello Russo

Introduction: Amniotic band syndrome (ABS) is an uncommon congenital anomaly characterized by multiple incapacitating manifestations. It may affect the bone, muscle, nerves, and vascular bundles according to the depth of the constriction band.
Material and methods: Here we present a 2-month-old infant patient with active ABS in the lower limb at risk for amputation, in which the constriction bands were released surgically using the extensive approach. A two-step surgery was performed. In the first step, a Z-plasty of the anterior portion of the proximal constriction band was performed. In a second step, the bag on the foot was removed and subsequently the posterior part of the constrictive band was resected.
Result: A follow-up of five years after surgery, respectively, revealed fully functional foot and restoration of blood supply.
Conclusion: This procedure allowed to establish normal circulation in the limb with active ABS after birth. Removal of the constriction band improves the distal tissue and avoids progressive deformity. Surgery of the SBA may be performed in one or two steps.