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Digital sucking induced trophic ulcers caused by nerve deficit from amniotic constriction band

Omar Beidas1, Ghazi M Rayan, A Al-Harthy

  • 1Temple University, Philadelphia, PA, USA.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|March 30, 2010
PubMed

Insights

Amniotic constriction bands (ACB) can cause late-onset neurological issues like skin ulcerations from digital sucking. Early extremity exams in infants with ACB are crucial for detecting hidden nerve problems.

Area of Science:

  • Pediatric Surgery
  • Neurology
  • Plastic Surgery

Background:

  • Amniotic constriction bands (ACB) are congenital limb anomalies.
  • Neurological complications in ACB are not well-documented.

Observation:

  • Two infants with distal forearm ACB developed recurrent digital ulcerations post-eruption.
  • Ulcerations were linked to digital sucking on insensate digits, primarily along the median nerve distribution.

Findings:

  • Surgical reconstruction involved Z-plasties, ulnar nerve neurolysis, and sural nerve grafting for the median nerve.
  • This case highlights a late-presenting neurological complication of ACB.

Implications:

  • Early and thorough physical examination of extremities in infants with ACB is vital.
  • Peripheral nerve exploration should be considered during soft tissue reconstruction for deep forearm ACB to prevent secondary complications.

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