Amniotic Bands



Deep skin crease encircling digit




1: 15 000




? Due to amniotic adhesions formed after haemorrhage in the distal rays


40% associated with other congenital hand abnormality


Streeter's syndrome

- hand and feet amniotic bands


Patterson Classification


1.  Simple Ring

- transversely around limb


2.  Deep Ring

- deformity, associated with lymphoedema of distal part


3.  Acrosyndactyly

- fingers formed, then bands form constriction

- proximal fingers open, distal closed


3.  Intrauterine amputations

- usually distal

- usually central fingers




Simple incomplete bands




Vascular compromise with complete bands




Release via multiple Z plasties

- bands with distal lymphoedema

- if band deep may need to be released as staged procedure



- excise a 1- 2 mm margin of normal skin and subcutaneous tissue to minimize the risk of recurrence

- resect all constricted fascia and muscle

- identify and protect neurovascular structures

- debulk excess subcutaneous tissue, especially dorsum fingers

- close the skin with multiple Z-plasties