Mutaf one-stage technique for congenital constriction rings: Safe and effective

Abstract

Introduction: Congenital constriction ring is a rare congenital malformation that especially affects the limbs. It is associated with fibrous bands that could encircle, strangle, or amputate some parts of the fetus. However, there are only a few techniques described for the correction of this anomaly. We aim to present a successful treatment of congenital constriction ring by means of the one-stage Mutaf technique. Patient Review: In our report, we presented two infants with congenital constriction rings. In the first case, we presented an infant with a constriction band on the right arm accompanied by deformity of the distal part and lymphoedema. In the second case, we presented an infant with multiple constriction bands on the distal part of the right leg with clubfeet and severe lymphoedema. They were both treated by the one-stage Mutaf technique using rectangular dermofat grafts to fill the groove. Using this technique we obtained a normal limb contour, with no oedema or neurovascular compromise. Filling the groove with the rectangular dermofat flaps parallel to the relaxed skin tension lines provides a better scar in comparison with multiple Zor W-plastics techniques. Additionally, advantages of the one-stage procedure are reduction of surgical and psychological trauma in patients and their parents, less time spent under general anesthesia and lower amount of anesthetic the patient receives, and lower treatment costs. Conclusion: We find the Mutaf technique to be an effective and safe technique for the treatment of congenital constriction rings.