A, Congenital ring syndrome with amputation of index finger and severe lymphedema of long finger. Good capillary refill was present at birth despite severe lymphedema; surgery was postponed for 1 month to lessen surgical risk. B, Radiograph showing hourglass deformity of proximal phalanx. C, Staged multiple Z-plasties performed. D, Lymphedema gradually diminished after Z-plasties. Active flexion and extension of digit were present. E to G, At 2 years’ follow-up.