Amniotic band syndrome is a sporadic condition that may result in constriction bands, amputation and multiple craniofacial, visceral and body wall defects. It occurs in 1/1,200 to 1/15,000 live births. Most cases present with multiple congenital anomalies that are incompatible with life. A small group of fetuses shows isolated limb constrictions that may cause severe limb dysfunction or limb amputation if left untreated. Successful in utero surgical lyses of constriction rings have been reported. We report a case of constriction amniotic bands involving both legs and compromising blood flow to the distal extremity. The constriction ring was successfully released by a minimally invasive endoscopic surgical technique avoiding severe limb dysfunction or foot amputation.

Background Temporomandibular joint (TMJ) total replacement with alloplastic prostheses has been performed since 1960s. Research in these last two decades has achieved important improvement in the development of biomaterials, design, adaptation, and fixation of the prosthesis components. Objective To evaluate total TMJ replacement with alloplastic prostheses. Methods We studied 27 patients, between 19 and 73 years old, who had total TMJ uni- or bilateral replacement surgery with custom-made alloplastic prostheses manufactured by TMJ Concepts, Inc. (Ventura, CA) between 1996 and 2011. The general data and preoperative measurements were taken from medical records. Subjective data related to pain, diet consistency, and current quality of life were collected with a questionnaire answered by the patients; measures of maximum interincisal opening and lateral mandibular movements were obtained from direct examination. Results We found significant difference (p < 0.05) comparing pre- to postoperative results about improvement in mouth opening, pain relief, and satisfaction with the surgery and diet consistency. Conclusion The results of this study show that total alloplastic TMJ prostheses are an efficient, safe, and stable long-term solution for patients who need TMJ total replacement.

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