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 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 Imaging May be helpful in identifying extent of underdevelopment and further organ system involvement Differential Treacher-Collins syndrome DIAGNOSIS Diagnosis is based primarily on clinical observations Treatment Prevention avoid exposure to thalidomide during pregnancy 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 Complications Permanent physical deformity leads to both physical limitation and emotional burden for children Prognosis Only 40% of infants born with this disorder survive