University of Central Florida's Linebacker, Shaquem Griffin, made history this week as the first one-handed player to be drafted in the NFL. If that isn't enough to inspire you, this feel-good story gets even better. He was drafted by the Seattle Seahawks, the same team who drafted his twin brother Shaquill last year. Shaquem's incredible story is front and center, but what actually is this amniotic band syndrome that caused him to lose his hand? Even though this isn't a sports injury per se, it's definitely worth digging deeper to understand what the rare condition that made Shaquem who he is today.
What is Amniotic Band Syndrome?
Amniotic band syndrome is a condition that occurs while the baby is still within the mother's uterus, also known as in utero. It is not a condition that occurs during the actual birth process as some have eluded to. The amniotic sac is a fluid-filled membrane that encloses and protects the baby within the uterus. The sac is composed of two distinct layers called the amnion layer (inner) and the chorion layer (outer). During early development, the amnion layer can develop tears or defects. These tears subsequently cause detached portions of the amnion layer to form fibrous bands within the amniotic sac. Consequently, these strands can become wrapped and entangled around the baby's limbs or digits, causing deformity or amputation. Studies have shown that the upper extremity and middle fingers are more vulnerable and much more likely to be entrapped than are other anatomic structures. The extent of hand injury can include underdevelopment, deformity, fusion or amputation of the fingers. However, the condition can affect multiple areas of the body including the body wall and skull, with no two cases being exactly the same.
According to media reports, Shaquem's condition was discovered prior to birth. Depending on the situation, a prenatal surgery can be attempted to release the constriction. However, due to being a twin pregnancy, it was thought to be too risky to attempt the surgery. Shaquem was born with significant deformity to the left hand which also caused severe chronic pain to the limb. In general, if the constriction is severe, the veins, arteries, lymphatics, and nerves may be compromised which can result in severe pain. When Shaquem was 4 years old, he underwent a surgical amputation of the left hand, after the severe pain caused him to plan to attempt to amputate his own fingers as reported by Sports Illustrated. As we all know, Shaquem's story has a happy ending no matter what happens in the NFL. However, the outcomes are not always as positive as this one. From the hand surgeon’s perspective, the most important aspect is that the structures of the hand more proximal to the constriction band are normal (Chung 2009). Therefore, after the amputation, the remainder of the limb has adequate function. Personally, I think his success, is in part, due to the amputation occurring at such a young age, giving the body time adapt. Fast forward to the NFL Combine where Shaquem runs a 4.38, 40 yard dash, and with a prosthesis puts up 20 reps on the bench press (3 more that his brother last year). We will see how this story ends, but Shaquem Griffin has given everyone a reason to smile, and amputees hope that they can do whatever they put their mind to.
Resource: Chung KC. et al, Constriction Band Syndrome. Hand Clinics. 2009 May;25(2):257-64.