Thalidomide Embryopathy and Limb Defects; Esperiences in Habilitation of Children with Ectromelias.

Abnormalities oflimbs have been seen occasionally at all times. Thalidomide-embryopathy, however, has produced special types of defects of the extremities, which in variety and above all in numbers has made necessary the provision of special centres for treatment. At the Dept. of Paediatric Surgery and Orthopaedics of the University Children's Hospital, Munich, we observed from January 1959 to December 1963 approximately 141 children with severe limb deformities, of which 135 children were diagnosed as the 'dysmelia syndrome' as defined by Wiedemann (1961), Lenz (1961), McBride (1961), Weicker and others (1962). Retrospectively 79% of the mothers were certain they had taken thalidomide during the critical phase of pregnancy, that is between the 32nd and the 50th day after the first day of the last menstruation. With another 16% we found that either thalidomide had been in the house or had been used by a member of the family, or that the mother had taken analgesic, hypnotic, or sedative drugs during the critical time. In only 5% of the mothers could we discover no reason for the abnormalities. Exactly 8 months after the voluntary withdrawal of all thalidomide-containing drugs by the firm concerned the wave of dysmelia cases suddenly retreated. During the following 16 months only 3 newborn babies with extremity defects were seen at the hospital, and these could all be distinguished from the dysmelia syndrome. In 1960 at this hospital we made our first efforts to treat dysmelic children. A treatment centre has now been established, working as an outpatient clinic for limb deformities. The cases are divided up as shown in the Table. The Dysmelia Centre was intentionally separated from the general hospital and was installed in an