KidsMD Health Topics

Constriction Ring Syndrome

  • Overview

    Constriction ring syndrome occurs when fibrous bands of the amniotic sac (the lining inside the uterus that contains a fetus) become entangled around a developing fetus.

    • It’s also known as amniotic band syndrome.
    • In some cases, the bands wrap around the fetus’ head or umbilical cord.
    • More commonly though, the bands wrap around a limb, fingers or toes, creating severe constrictions. It’s similar to what happens when you wrap a rubber band around your arm or leg.

    The Hand and Orthopedic Upper Extremity Program

    The Hand and Orthopedic Upper Extremity Program provides comprehensive care involving occupational and physical therapy, splinting, casting and reconstructive surgeries for infants, children and adolescents with complex congenital, neuromuscular, sports-related oncologic and traumatic upper limb conditions.

    The Hand and Reconstructive Microsurgery Program

    The specialists in the Hand and Reconstructive Microsurgery Program at Children's are experts in the management of congenital and acquired hand deformities. We recognize the social elements involved in pediatric hand surgery, so an essential part of these operations has been making the child?s hand as symmetrical as possible with his unaffected hand.

  • In-Depth

    What is constriction ring syndrome?

    Constriction ring syndrome occurs when fibrous bands of the amniotic sac (the lining inside the uterus that contains a fetus) become entangled around a developing fetus.

    In some cases, the bands wrap around the fetus's head or umbilical cord. More commonly though, the bands wrap around a limb, fingers or toes, creating severe constrictions. It’s similar to what happens when you wrap a rubber band around your arm or leg.

    Constriction ring syndrome is also known as:

    • ADAM Complex
    • amniotic band sequence
    • amniotic band syndrome
    • amniotic disruption complex
    • amniochorionic mesoblastic fibrous strings
    • congenital amputation
    • constriction band syndrome
    • congenital constricting bands
    • Streeter bands
    • tissue bands

    What causes constriction ring syndrome?

    The exact cause of the syndrome is unknown, but it’s not believed to be hereditary. Many times, it seems to occur for no apparent reason.

    How common is constriction ring syndrome?

    Constriction ring syndrome occurs in about 1 in every 10,000 to 15,000 babies. Researchers think it occurs more frequently in the fingers than in the toes.

    Is it dangerous?

    Constriction ring syndrome sometimes results in nothing more than an unsightly, circular indentation around your child’s finger or limb.

    Deeper bands can cause some more serious problems:

    • severe swelling
    • restriction of the lymphatic or venous flow
    • interference with development of the arm or leg

    If a band is tight enough, the constriction may even cause an in utero (before birth) amputation of the arm or the leg.

  • Tests

    How is constriction ring syndrome diagnosed?

    Occasionally, constriction ring syndrome can be diagnosed before birth by prenatal ultrasound. However, the majority of cases are diagnosed at or shortly after birth by your child’s doctor.

    X-rays of your child’s affected limb are also used to help assess how deep and tight the band is.

  • What are the treatment options for my child?

    Your child will receive individualized treatment decided upon by his doctor.

    • If your child has shallow, incomplete constriction rings, he may be treated with a simple day surgical procedure.
    • If your child has deep constriction rings, one or more surgeries may be required to improve the appearance and function of the affected hand.

    Surgery is usually performed after your child has had time to grow (when he's 6 months to 1 year old), though deep constriction rings that restrict blood flow must be treated immediately.

    What's my child's long-term outlook?

    Despite the differences in appearance, affected hands and fingers generally have excellent long-term function.

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