Pondicherry Journal of Nursing

Register      Login

VOLUME 14 , ISSUE 3 ( July-September, 2021 ) > List of Articles

REVIEW ARTICLE

Constriction Ring Syndrome

Jaya Pradha Dhandapani, Venkateshvaran Ponnusamy

Keywords : Abnormalities, Congenital, Constriction ring syndrome, Malformation

Citation Information : Dhandapani JP, Ponnusamy V. Constriction Ring Syndrome. 2021; 14 (3):62-65.

DOI: 10.5005/jp-journals-10084-13104

License: CC BY-NC 4.0

Published Online: 30-10-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

The inborn constriction ring syndrome (CRS) encloses collective anomalies that develop in various amalgamation, typically damaging the lower extremities (limbs) and hardly the head as well as trunk. This syndrome has an inherited limb deformities. These anomalies with a variety of diagnostic presentations were described by showing the partial to complete, inherit, fibrous, circumferential, constriction bands or rings on any parts of the body, even though a particular predilection for both upper and lower extremities is visible. The CRS incidence differs from one case in 1500–15,000 live births. Eighty percent of cases happen in digits and upper extremities. More than 90% presents in the region of distal to wrist area. The familial ratio is relatively low, and it is thought that there is no inborn involuntary component to this disease. The diagnostic measures regarding the CRS can be authenticated with the help of ultrasonography. The clinical features may be totally different, and also, it could be due to one or more manifestations. This can be validated at the end of the first trimester or at the beginning of the second trimester. The treatment commonly follows after birth and where plastic and reconstructive surgery is believed to treat the resulting deformation. Plastic surgery was classified from simple to complex based on the extent of the deformity. Physical and occupational therapy may be necessary for a prolonged period. Amniotic band syndrome is considered an accidental event, and it does not appear to be genetic or hereditary, so the likelihood of it occurring in another pregnancy is distant. The reason for amnion tearing is not known, and as such, there are no known prophylactic measures. Congenital CRS is of unknown etiology and can lead to morbidity in the newborn. The syndrome and its complications are controllable with corrective surgery with good outcomes. Early intervention is agreeable for successful results.


PDF Share
  1. Higginbottom MC, Jones KL, Hall BD, et al. The amniotic band disruption complex: timing of amniotic rupture and variable spectra of consequent defects. J Pediatr 1979;95(4):544–549. DOI: 10.1016/s0022-3476(79)80759-3.
  2. Light TR, Ogden JA. Congenital constriction band syndrome. Pathophysiology and treatment. Yale J Biol Med 1993;66(3):143–155. Available at: https://pubmed.ncbi.nlm.nih.gov/8209551/.
  3. Poeuf B, Samson P, Magalon G. Amniotic band syndrome. Chir Main 2008;27(Suppl 1):S136–S147. DOI: 10.1016/j.main.2008.07.016.
  4. Burk CJ, Aber C, Connelly EA. Ehlers-Danlos syndrome type IV: keloidal plaques of the lower extremities, amniotic band limb deformity, and a new mutation. J Am Acad Dermatol 2007;56(2 Suppl):S53–S54. DOI: 10.1016/j.jaad.2006.11.008.
  5. Patterson TJ. Congenital ring-constriction. Br J Plast Surg 1961;14:1–31. DOI: 10.1016/s0007-1226(61)80002-7.
  6. Patterson TJ. Syndactyly and ring constrictions. Proc R Soc Med 1969;62(1):51–53. Available at: https://pubmed.ncbi.nlm.nih.gov/4303223/.
  7. Streeter G. Focal deficiencies in fetal tissues and their relation to intrauterine amputations. Contrib Embryol 1930;22:1–44, DOI: December 05,2014,Vol- 4.No: 16
  8. Moerman P, Fryns JP, Vandenberghe K, et al. Constrictive amniotic bands, amniotic adhesions, and limb-body wall complex: discrete disruption sequences with pathogenetic overlap. Am J Med Genet 1992;42(4):470–479. DOI: 10.1002/ajmg.1320420412.
  9. Torpin R. Amniochorionic mesoblastic fibrous strings and amniotic bands: associated constricting fetal malformations or fetal death. Am J Obstet Gynecol 1965;91:65–75. DOI: 10.1016/0002-9378(65)90588-0.
  10. Robin NH, Franklin J, Prucka S, et al. Clefting, amniotic bands and polydactyl: a distinct phenotype that supports an intrinsic mechanism for amniotic band sequence. Am J Med Genet B Neuropsychiatry Genet Part A 2005;137A(3):298–301. DOI: 10.1002/ajmg.a.30885.
  11. Lateo SA, Taylor AE, Meggitt SJ. Raised limb bands developing in infancy. Br J Dermatol. 2006;154(4):791–792. DOI: 10.1111/j.1365-2133.2006.07160.x.
  12. Werler MM, Louik C, Mitchell AA. Epidemiologic analysis of maternal factors and amniotic band defects. Birth Defects Res A Clin Mol Teratol 2003;67(1):68–72. DOI: 10.1002/bdra.10001.
  13. Fathallah ZF. Unusual presentation of amniotic band syndrome. Bas J Surg 2007;11:77–79.
  14. Jabor MA, Cronin ED. Bilateral cleft lip and palate and limb deformities: a presentation of amniotic band sequence? J Craniofac Surg 2000;11(4):388–393. DOI: 10.1097/00001665-200011040-00021.
  15. Evans C, Marton T, Rutter S, et al. Cranial vault defects: the description of three cases that illustrate a spectrum of anomalies. Pediatr Dev Pathol 2009;12(2):96–102. DOI: 10.2350/08-02-0415.1.
  16. McGuirk CK, Westgate MN, Holmes LB. Limb deficiencies in newborn infants. Paediatrics 2001;108(4):e64–e70. DOI: 10.1542/peds.108.4.e64.
  17. Dilek TUK, Yazici G, Gulhan S, et al. Amniotic band syndrome associated with cranial defects and ectopiacordis: a report of two cases. J Turkish German Gynecol Assoc 2005;6(4):308–310.
  18. Ogino T, Saitou Y. Congenital constriction band syndrome and transverse deficiency. J Hand Surg Br 1987;12:343–348. DOI: 10.1016/0266-7681(87)90185-9.
  19. Garza A, Cordero JF, Mulinare J. Epidemiology of the early amnion rupture spectrum of defects. Am J Dis Child 1988;142:541–544. DOI: 10.1001/archpedi.1988.02150050079037.
  20. Weinzweig N, Barr A. Radial, ulnar and median nerve palsies caused by a congenital constriction band of the arm: single stage correction. Plast Reconstr Surg 1994;94:872–876. DOI: 10.1097/00006534-199411000-00022.
  21. Allen LM. Constriction rings and congenital amputations of the fingers and toes in a mild case of amniotic band syndrome. JDMS 2007;23:280–285. DOI: September 1, 2007.
  22. Merrimen JL, McNeely PD, Bendor-Samuel RL, et al. Congenital placental-cerebral adhesion: an unusual case of amniotic band sequence. Case report. J Neurosurgeon 2006;104(5 Suppl):352–355. DOI: 10.3171/ped.2006.104.5.352.
  23. Rossillon D, Rombouts JJ, Verellen-Dumoulin C, et al. Congenital ring-constriction syndrome of the limbs: a report of 19 cases. Br J Plast Surg 1988;41:270–277. DOI: 10.1016/0007-1226(88)90111-7.
  24. Upton J. Constriction ring syndrome. In: Mathes SJ, editor. Plastic surgery. The hand and upper limb, part 2. Vol. 8. 2nd ed. Philadelphia: Saunders Elsevier, 2006, pp. 185–213.
  25. Kino Y. Clinical and experimental studies of the congenital constriction band syndrome, with an emphasis on its etiology. J Bone Joint Surg Am 1995; 57:636–643. Available at: https://pubmed.ncbi.nlm.nih.gov/1150705/.
  26. De Pablo A, Calb I, Jaimovich L. Congenital constriction bands: amniotic band syndrome. J Am Acad Dermatol 1995;32:528–529. DOI: May 2014, ISSN NO 2277- 8179, issue :5, vol: 3.
  27. Jobe MT, Wright PE. Congenital anomalies of hand: congenital ring syndrome. In: Terry Canale S, editor. Campbell's operative orthopaedics. 9th ed. St Louis: Mosby, 1999, p. 80.
  28. Gibson T. Pierre-Joseph Cecilien Simonart (1816-1846) and his intrauterine bands. Br J Plast Surg 1977;30:261–262. DOI: 10.1016/0007-1226(77)90112-6.
  29. Pillay VK, Hesketh KT. Intra-uterine amputations and annular limb defects in Singapore. J Bone Joint Surg Br 1965;47:514. Available at: https://pubmed.ncbi.nlm.nih.gov/14341070/.
  30. Moses JM, Flatt AE, Cooper RR. Annular constricting bands. J Bone Joint Surg Am 1979;61:562–565. Available at: https://pubmed.ncbi.nlm.nih.gov/374416/.
  31. Hunter AG, Carpenter BF. Implications of malformations not due to amniotic bands in the amniotic band sequence. Is J Med Genet 1986;24:691. DOI: 10.1002/ajmg.1320240414.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.