title: Single-Stage Resection of Type II Constriction Rings in Limbs on the Basis of Histologic and Magnetic Resonance Imaging Observations: A Retrospective Study of 21 Consecutive Patients.
abstract: BACKGROUND
  The purpose of this study was to determine the feasibility of single-stage resection for type II congenital constriction rings by means of histologic examination of resected specimens and imaging examination of affected extremities, and to evaluate the appearance and function of the extremities after single-stage surgery.
  
  
  METHODS
  The features of the skin on the constriction rings and the subcutaneous tissues were identified through continuous sectioning, hematoxylin and eosin staining, and immunohistologic staining of specimens of type II constriction rings obtained by means of surgery. The relationship between the constriction rings and the deep main blood vessels was evaluated using magnetic resonance imaging. Single-stage resection of the constriction band, reduction of the fascial flap, and triangular flap-plasty were performed for 21 patients. The appearance, lymphedema, and movement of the extremities were compared before and after the operation.
  
  
  RESULTS
  Type II constriction rings in the extremities had normal full-layer skin structures. Collagen was found deposited densely at the base of the grooves, but the normal subcutaneous tissue space remained, and the vital nerves and blood vessels were unaffected. Complete resection of the constriction rings was achieved in all 21 patients, and lymphedema subsided 2 months after the operation. No episode of recurrence was found, and limb function was not affected at 26-month follow-up.
  
  
  CONCLUSIONS
  Type II congenital constriction rings in limbs possess normal subcutaneous tissue spaces. A single-stage operation, which includes complete resection of the rings, fascial flap reduction, and triangular flap-plasty, could achieve a satisfactory appearance and good function.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine; and the Department of Anesthesiology and Critical Care Medicine, Zhongshan Hospital, Fudan University.
authors.forename: Yongkang
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine; and the Department of Anesthesiology and Critical Care Medicine, Zhongshan Hospital, Fudan University.
authors.forename: Hailei
authors.initials: H
authors.lastname: Mao
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine; and the Department of Anesthesiology and Critical Care Medicine, Zhongshan Hospital, Fudan University.
authors.forename: Xi
authors.initials: X
authors.lastname: Yang
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine; and the Department of Anesthesiology and Critical Care Medicine, Zhongshan Hospital, Fudan University.
authors.forename: Shengbo
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine; and the Department of Anesthesiology and Critical Care Medicine, Zhongshan Hospital, Fudan University.
authors.forename: Feng
authors.initials: F
authors.lastname: Ni
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine; and the Department of Anesthesiology and Critical Care Medicine, Zhongshan Hospital, Fudan University.
authors.forename: Qiming
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine; and the Department of Anesthesiology and Critical Care Medicine, Zhongshan Hospital, Fudan University.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
mesh_terms: D000652:Amniotic Band Syndrome / Q000175:diagnosis / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D038061:Lower Extremity Deformities, Congenital / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D038062:Upper Extremity Deformities, Congenital / Q000175:diagnosis / Q000601:surgery*