Related Experiment Video
Updated: Jul 12, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Club Foot with Contralateral Congenital Amniotic Band Syndrome Amputation Successfully Treated with Ponseti Method:
Brian Le1, Srikanth Mudiganty1, Timothy Skalak1
1Department of Orthopedics Childrens Hospital New Orleans, Louisiana, USA.
Insights
Constriction amniotic band syndrome (CABS) can cause clubfoot deformities. The Ponseti method, combined with a custom prosthesis after amputation, effectively corrects CABS-associated clubfoot and prevents relapse.
Area of Science:
- Pediatric Orthopedics
- Fetal Medicine
- Genetics
Background:
- Constriction amniotic band syndrome (CABS) is a rare congenital disorder affecting approximately 1 in 15,000 live births.
- CABS can lead to fetal malformations, including clubfoot, which historically presented challenges due to high relapse rates after treatment.
- Traditional treatments for CABS-associated clubfoot often involved extensive soft-tissue release procedures.
Observation:
- A premature infant (27 weeks gestation) presented with non-viable tissue in the right leg requiring amputation and a left-sided clubfoot deformity.
- The left clubfoot was successfully treated using the Ponseti method, including serial casting and Achilles tenotomy.
- A custom prosthesis for the right leg was fitted at 6 months of age, enabling the use of an abduction foot orthosis for the left foot.
Findings:
- This case demonstrates that the Ponseti method is effective for correcting CABS-associated clubfoot, even in complex cases.
- The use of a custom-fitted prosthesis facilitated the application of a corrective orthosis, successfully maintaining the clubfoot correction.
- This approach mitigated the challenges posed by a contralateral amputation in managing the clubfoot deformity.
Implications:
- The findings support the use of the Ponseti method as a primary treatment for CABS-associated clubfoot.
- Custom prosthetics offer a viable solution for applying corrective orthoses in cases with limb amputation.
- This strategy can improve outcomes and prevent relapse in infants with CABS and complex limb deformities.
Introduction:
Constriction amniotic band syndrome (CABS) is a rare condition associated with the fibrous amniotic bands that restrict and ensnare the fetus in utero resulting in malformations at birth in one per around 15,000 live births. CABS associated with clubfoot, historically required extensive soft-tissue release due to its propensity for relapse.
Case Report:
A 2-day-old Caucasian male infant born at 27 weeks gestation through emergency cesarean section due to concern for placental abruption and premature rupture of membranes in the setting of a prenatal history significant for oligohydramnios. The patient presented with non-viable tissue in the right leg requiring amputation with a left-sided clubfoot deformity. Following amputation of the right leg, the clubfoot was corrected with Ponseti method of serial casting and Achilles tenotomy. Three-week post-tenotomy and 6 months of age, a custom fit prosthesis of the right leg allowed for the application of a left abduction foot orthosis which maintained the correction.
Conclusion:
This case study supports recent literature that CABS-associated clubfoot can be corrected with the Ponseti method. While a contralateral amputation can prevent the use of a traditional bilateral abduction foot orthosis, a custom fitted prosthesis can allow for its use and prevention of a relapse of deformity.
