PSEUDO AINHUM - A PROSPECTIVE STUDY

Abstract

Background: Amniotic band syndrome also known as ADAM complex, amniotic
band sequence, congenital constrictions, bands and Pseudo Ainhum is a congenital disorder
caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in
utero. Syndrome which is featured by one or more characteristic fibrous bands that encircle,
deepen, strangulate and amputate parts of the human body. It start in a fetus & continues
throughout life if not checked and treated . It is not an uncommon condition in our country but
unfortunately data remains scarce. Design: A prospective study. Setting: Pediatric & General
Surgical Department of CMH Multan. Period: June 2010 to June 2012. Materials and methods:
Characteristic progressive constriction band was undertaken. The patients were examined
clinically and findings recorded. An X-ray to rule out underlying bone anomaly was done.
Treatment required multiple staged procedures. Correction of the constriction ring was done by
excision and Z-plasty to prevent or alleviate lymphoedema, separation of distally fused digits and
skin grafting of defect. Results: Fifteen patients comprising of ten male & five females were
seen. Age of presentation ranged from second week of life to 12 years with mean age of 14
months. A total of twenty one limbs and one penile shaft were effected. These included two right
upper limbs, three left upper limbs, ten right lower limbs and six left lower limbs. Penile shaft of
one of the patients just short of glans was involved. Four main types of lesions were found which
comprised of constriction rings, intra uterine amputations, acrosyndactyl and simple syndactyl.
Conclusions: Pseudo Ainhum is a disease of unknown etiolgy & could cause morbidity in new
born. The syndrome & its complications are amenable to corrective surgery with good results.
Early surgery is required for successful outcome.