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Figure 5.63. The same infant showing a close-up of the right wrist and hand. Note the dimples at the contracture site. In this condition there may be cord wrapping of the limb and amniotic bands.

Figure 5.61. Lateral view of the same infant shows the marked underdevelopment of the hips, the arthrogryposis, webbing, and the dimples at the joints due to lack of movement. Note the talipes calcaneovalgus.

Figure 5.62. An infant with an amyoplasia congenita disruptive sequence. In this condition the elbows are usually in extension with the wrists and hands flexed.

Figure 5.63. The same infant showing a close-up of the right wrist and hand. Note the dimples at the contracture site. In this condition there may be cord wrapping of the limb and amniotic bands.

Figure 5.64. This figure shows the left hand of the same infant. Note the lack of development of the finger and hand creases. Lack of development of the creases indicates lack of fetal movement of the fingers occurring before the 10th to 12th week of gestation.

Figure 5.64. This figure shows the left hand of the same infant. Note the lack of development of the finger and hand creases. Lack of development of the creases indicates lack of fetal movement of the fingers occurring before the 10th to 12th week of gestation.

Figure 5.65. There is an intrauter-ine constriction band at the right wrist in this infant. Shallow constricting rings can encircle a limb at any level and destroy subcutaneous tissue sometimes producing distal edema. Amniotic bands may result in constriction or amputation (partial or complete) of extremities and are thought to occur as a result of an active fetus pushing an extremity through and tearing the amnion. This represents an example of The Early Amnion Rupture Spectrum (TEARS).

Figure 5.66. The congenital anomaly of the fourth finger of the left hand in this infant is due to an amniotic band. Also note the collodion appearance of the skin of this postmature infant. The hands and feet (and especially the digits) are the most common sites of damage from amniotic bands. If there is mild constriction, distal edema is produced; with more severe compression there can be disruption of tissue down to the periosteum with eventual loss of the distal avascular portion - a congenital amputation. The findings in such infants are bizzare and very variable.

Figure 5.65. There is an intrauter-ine constriction band at the right wrist in this infant. Shallow constricting rings can encircle a limb at any level and destroy subcutaneous tissue sometimes producing distal edema. Amniotic bands may result in constriction or amputation (partial or complete) of extremities and are thought to occur as a result of an active fetus pushing an extremity through and tearing the amnion. This represents an example of The Early Amnion Rupture Spectrum (TEARS).

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