PEROMELIA

congenital absence or malformation of the extremities, of rare occurrence until the thalidomide tragedy in the early 1960s. Peromelia is caused by errors in the formation and development of the limb bud from about the fourth to the eighth week of intrauterine life. In amelia, one of the rarest of malformations of the extremities, limbs are completely absent. Ectromelia is the absence of one or more extremities. In phocomelia ("seal extremity") the upper part of the limb is extremely underdeveloped or missing, and the lower part is attached directly to the trunk, resembling the flipper of a seal. Hemimelia is a condition in which the upper part of the limb is well formed but the lower part is rudimentary or absent. Sirenomelia ("mermaid extremity") is a severe abnormality in which the legs are fused to a greater or lesser degree and contain malformed bones, the anal and urinary orifices are absent, and the genitals and parts of the intestinal and urinary tracts malformed. Treatment of major limb malformations involves the fitting of prostheses and special training in their use. Surgery is used with success in relieving minor malformations.