Amniotic Band Syndrome (ABS) is a congenital condition caused by fibrous bands that constrict the developing limb. Involvement of the lower leg may cause circumferential constriction rings, distal lymphedema, impaired circulation, nerve compression, and, in severe cases, loss of distal part of the limb.
Management Plan:
Clinical assessment: Evaluation of the depth of the constriction ring, distal swelling, skin condition, capillary refill, pulses, sensation, and limb function.
- Mild cases: Observation with regular follow-up if circulation and limb function are normal.
- Significant constriction: Elective surgical release, particularly when there is progressive swelling, deep constriction, or functional impairment.
Surgical Management
Excision of the constricting band with careful preservation of neurovascular and lymphatic structures and reconstruction by multiple Z-plasties in 2 or single stages.
Timing of surgery:
Urgent release is indicated for vascular compromise or threatened tissue viability. Otherwise, elective surgery can be planned at3 to 6 months according to the severity of constriction, oedema, and functional impairment.