Constriction Rings: The Missing Link
Mark Kiehn, MDa, David Leshem, MDb and Ronald Zuker, MD, FRCSC, FASC, FAAPc

aDivision of Plastic Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin bDepartment of Plastic & Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, IsraelcDivision of Plastic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada

Correspondence: mwkiehn@gmail.com

Objective: Amniotic band syndrome is an uncommon clinical entity with a spectrum of presentation including constriction rings, syndactyly, amputations, and spontaneous abortion. The bands themselves are not present at the time of birth. This has created controversy regarding the pathogenesis of the disorder. Methods: The unusual case of a neonate with a persistent band of fibrous amniotic material and the associated deformity of a constriction ring is evaluated. The significance of this unique case is discussed in the context of existing understanding of the syndrome. Results: The amniotic band was released in the neonatal intensive care unit shortly after birth. Despite removal of the band, the constriction ring persisted. Conclusion: The presence of a fibrous amniotic band at the site of a constriction ring is an extremely unusual finding. This case further demonstrates the importance of amniotic material in the etiology of constriction rings.


Amniotic band syndrome is an uncommon clinical entity that has been recognized for centuries.1,2 The manifestations of a .......