Snapshot Following the release of an over-the-counter anti-emetic medication, several thousand children were born with varying degrees of aural and limb deformities. Introduction Congenital deformity of the limbs linked to chromosome 8 Deformities can range from face, nose, ears, limbs, and vascular abnormalities Most often associated with the use of thalidomide Can occur spontaneously via autosomal recessive inheritance Epidemiology peak incidence following release of OTC thalidomide in Germany in 1960 since awareness of thalidomide association, phecomelia has grown extremely rare Presentation Symptoms undeveloped limbs short arms underdeveloped, absent, or fused digits small head wide-set eyes cleft lip and/or palate small chin Physical exam underdeveloped or absent pelvic girdle growth retardation in utero and after birth hypertelorism microcephaly encephalocele abnormal uterus kidney and cardiac malformations Evaluation Diagnosis is based primarily on clinical observations Imaging may be helpful in identifying extent of underdevelopment and further organ system involvement Differential Treacher-Collins syndrome Treatment Medical management prostheses may be adequate substitude for missing limbs, teeth, etc Surgical intervention reconstructive surgery usually limited due to absence of significant amount of tissue, nerves, and bone Prognosis, Prevention, and Comlication Prognosis only 40% of infants born with this disorder survive Prevention avoid exposure to thalidomide during pregnancy Complications permanent physical deformity leads to both physical limitation and emotional burden for children