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Annular Band Syndrome

- Discussion:
    - annular bands may present clinically with either complete amputation of part of thumb as well as the rest of the hand;
    - constriction bands higher up in the arm, causing severe edema in parts distal to the constriction band;
    - annular bands are often associated w/ acrosyndactyly;
    - annular band syndrome is sporadic, not inherited;
    - inherent in this anomaly are hypoplasia, brachydactyly, symphalangism, symbrachydactyly, and congenital amputations;

- Treatment:
    - in past, recommended treatment called for the surgeon to stage at least two Z-plasties to remove the constriction band;
    - currently many recommend removal of the entire band at one operation;
    - when bands involve the digits, extreme care must be exercised to prevent necrosis of the tips of the already shortened digits;
    - syndactyly:
         - must be released and the bones aligned to create three or four fingers

Annular constricting bands.

Congenital constriction band syndrome.

The four-flap Z-plasty.

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