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Presentation and multidisciplinary management of a unique case of lower limb dysmelia resulting from amniotic band syndrome
  1. Katherine Radcliffe,
  2. Kajal Gohil and
  3. James D Bedford
  1. Burns and Plastic Surgery, Manchester University NHS Foundation Trust, Manchester, UK
  1. Correspondence to Katherine Radcliffe; katherine.radcliffe{at}


A neonate was born with a unique congenital lower limb dysmelia due to an abnormal presentation of amniotic band syndrome. An anomalous soft tissue tether from the plantar surface of the right foot to the right buttock caused extreme knee flexion, tibial rotation and malformation of the developing foot. This complex malformation required a multidisciplinary team (MDT) approach to decide between reconstruction and amputation. The band of tissue was released operatively at 73 days postdelivery, improving knee extension, and the tissue was banked on the thigh as a tube pedicle for future reconstruction. The patient underwent rehabilitation, which has been shown to be vital for synovial joint formation. At 18 months old, the decision was made to proceed with through-knee amputation and a prosthesis. The literature discussed shows the importance of an MDT approach in complex lower limb cases to give the best functional outcome for the patient.

  • congenital disorders
  • paediatric surgery
  • plastic and reconstructive surgery
  • healthcare improvement and patient safety
  • medical management

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  • Contributors KR and KG were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. JDB gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.