Top

Journal of Children's Orthopaedics

Published in:

01-07-2012 | Original Clinical Article

Congenital constriction ring in children: sine plasty combined with removal of fibrous groove and fasciotomy

Author: Nguyen Ngoc Hung

Published in: Journal of Children's Orthopaedics | Issue 3/2012

Abstract

Objective

To evaluate the clinical and functional results of a technical procedure used in the surgical treatment of congenital constriction ring (CCR) in children.

Materials and methods

This was a retrospective study undertaken to evaluate the results of surgical techniques performed from January 1995 to December 2005 on 95 patients with 134 congenital constriction bands. Due to the drop-out of nine patients during follow-up, data on 86 patients (121 congenital constriction rings; average age at surgery 1 year 2 months) were analyzed. The extent of the constrictions was classified by according to the Patterson criteria. All patients were treated by two-stage sine plasty combined with removal of the fibrous groove and fasciotomy, with one-half of the ring removed during the first stage and the other half removed 1 week later during the second state. The surgical outcomes were assess according to the Moses criteria.

Results

Three types of CCR (Patterson criteria) were identified among the 86 patients (121 constriction rings): types I (5 patients, 4.1 %), II (107, 88.5 %), III (9, 7.4 %). Of the 121 constriction rings, good results were attained in 73.6 % and fair results in 26.4 %. Sensory deficits were seen in six patients immediately after the surgery but all six had improved to a normal condition at the final follow-up examination. There were no skin necrosis or wound healing problems.

Conclusion

The combined sine plasty/removal of fibrous groove and fasciotomy method reported here is a simple and safe surgical technique for treating CCR in children.

Montgomery WF (1832) Observation on the spontaneous amputation of the limbs of the fetus in utero, with an attempt to explain the occasional cause of its production. Dublin Med Chem Sci J 1:140–144CrossRef

Gorlin RJ, Cohen MM Jr, Hennekam RCM. Syndromes of the head and neck, 4th edn. Oxford University Press, New York, pp 10–13

Jones K (2005) Smith’s recognizable patterns of human malformation, 6th edn. WB Saunders, Philadelphia

Kiehn M, Leshem D, Zuker R (2007) Constriction rings: the missing link. Eplasty 8:4

Robin NH, Franklin J, Prucka S, Ryan AB, Grant JH (2005) Clefting, amniotic bands, and polydactyly: a distinct phenotype that supports an intrinsic mechanism for amniotic band sequence. Am J Med Genet A 137:298–301CrossRef

Rayan GM (2002) Amniotic constriction band. J Hand Surg [Am] 27:1110–1111CrossRef

Stevenson TW (1946) Release of circular constricting scars by Z flaps. Plast Reconstr Surg 1:39–42CrossRef

Takayuki M (1984) Congenital constriction band syndrome. J Hand Surg 9A:82–88

Mehmet M, Mahmut S (2006) A new technique for correction of congenital constriction rings. Ann Plast Surg 57:646–652CrossRef

10.

Yohanness M, Williams HB (2008) Surgical correction of congenital constriction band syndrome in children: replacing Z-plasty with direct closure. Can J Plast Surg 16(4):221–223

11.

Patterson T (1961) Congenital ring constrictions. Br J Plast Surg 69:532–569

12.

Koichi T, Kazuo Y, Swanson AB (1984) Congenital constriction band syndrome. J Pediatr Orthop 4:726–730CrossRef

13.

Tada K, Yonenobu K, Swanson AB (1984) Congenital constriction band syndrome. J Pediatr Orthop 1984(4):726–730CrossRef

14.

Moses JM, Flatt AE, Cooper RR (1979) Annular constricting bands. J Bone Joint Surg 61-A(4):562–565

15.

Patterson TJ (1961) Congenital ring constrictions. Br J Plast Surg 14:1–31CrossRef

16.

Kay SP, McCombe D (2005) Absence of fingers. In: Green DP, Hotchkiss RN, Pedersen WC, Wolfe SC (eds) Green’s operative hand surgery. Elsevier, Philadelphia, pp 1415–1430

17.

Upton J (2006) Constriction ring syndrome. In: Mathes SJ, Hentz UR (eds) Plastic surgery. Elsevier, Philadelphia, pp 185–213

18.

Upton J (1990) Congenital anomalies of the hand and forearm. In: McCarthy J, May JW, Little J (eds) Plastic surgery. WB Saunders, Philadelphia, pp 5373–5378

19.

Hall EJ, Johnson-Giebink R, Vasconez LO (1982) Management of the ring constriction syndrome: a reappraisal. Plast Reconstr Surg 69:532–536CrossRef

20.

Streeter GL (1930) Focal deficiencies in fetal tissues and their relation to intra-uterine amputation. Contrib Embryol 22:1–44

21.

Mutaf M, Sunay M (2006) A new technique for correction of congenital constriction rings. Ann Plast Surg 2006(57):646–652CrossRef

22.

Di Meo I, Mercer DH (1987) Single stage correction of constriction ring syndrome. Ann Plast Surg 19:469–474CrossRef

23.

Muguti GI (1990) The amniotic band syndrome-single stage correction. Br J Plast Surg 43:706–714CrossRef

24.

Beaty JH (1992) Congenital anomalies of lower extremity. In: Crenshaw AH (ed) Campbell’s operative orthopaedics, vol 3. Mosby, St. Louis, pp 2061–2158

25.

Baker C Jr, Rudolf AJ (1971) Congenital ring constriction and intrauterine amputations. Am J Dis Child 121:393–400

26.

Greg A, Errol G (1988) Congenial constriction band syndromes. J Pediatr Orthop 8:461–466CrossRef

27.

Sanmugasundaram TK (1999) Congenital anomalies. In: Kulkarni GS (ed) Textbook of orthopaedics and trauma, vol 4. Jaypee Brothers Medical Publishers, Chennai, pp 3439–3947

28.

Tachdian MO (2002) Paediatrics orthopaedics, vol 1, 3rd edn. W.B Saunders, Philadelphia, pp 461–466

29.

Upton J, Tan C (1991) Correction of constriction rings. J Hand Surg 16A:947–953CrossRef

30.

Greene WB, Hill C (1993) One stage release of congenital circumferential constriction bands. J Bone Joint Surg Am 75:650–655

31.

Visuthikosol V, Hompuem T (1988) Constriction band syndrome. Ann Plast Surg 21:489–495CrossRef

32.

Daniel RK, Williams HB (1973) The free transfer of skin flaps by microvascular anastornoses. An experimental study and a reappraisal. Plast Reconstr Surg 52:16–31CrossRef

33.

Wanter BG (1993) One-stage release of congenital circumferential constriction bands. J Bone Joint Surg 75(5):650–655

34.

Quintero RA, Morales WJ, Phillips J, Kalter CS, Angel JL (1997) In utero lysis of amniotic bands. Ultrasound Obstet Gynecol 10:316–320CrossRef

35.

Sentilhes L, Verspyck E, Eurin D, Ickowicz V, Patrier S, Lechevallier J, Marpeau L (2004) Favourable outcome of a tight constriction band secondary to amniotic band syndrome. Prenat Diagn 24:198–201CrossRef

Title: Congenital constriction ring in children: sine plasty combined with removal of fibrous groove and fasciotomy
Author: Nguyen Ngoc Hung
Publication date: 01-07-2012
Publisher: Springer Berlin Heidelberg
Published in: Journal of Children's Orthopaedics / Issue 3/2012
Print ISSN: 1863-2521
Electronic ISSN: 1863-2548
DOI: https://doi.org/10.1007/s11832-012-0420-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Congenital constriction ring in children: sine plasty combined with removal of fibrous groove and fasciotomy

Abstract

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2012

The modulation of spinal growth with nitinol intervertebral stapling in an established swine model

Hip impingement in slipped capital femoral epiphysis: a changing perspective

Primary obturator-muscle pyomyositis in immunocompetent children

Intramedullary nails for pediatric diaphyseal femur fractures in older, heavier children: early results

Reliability of plain radiographic parameters for developmental dysplasia of the hip in children

Birth-related femoral fracture in newborns: risk factors and management