Hair Tourniquet Syndrome in the Pediatric Population: A Case Report
Abstract
Tourniquet syndrome is a rare condition that usually affects the pediatric population. It consists of a decrease in blood supply due to circumferential strangulation of some parts of the body, mainly fingers or toes, external genitalia or other appendages.In most cases, the causative agent is usually a strand of hair, although other elements have been described, such as synthetic fibers from the patient’s clothing. The aim of this study is to report a case of a patient with hair tourniquet syndrome and to review the available literature. The patient is a 3-month-old female with hair tourniquet syndrome, with involvement of the fourth toe of the right foot, who was brought to the emergency department for significant soft tissue edema. The patient evolved favorably after removal of the causative agent (hair strand) from the base of the fourth toe and recovery of irrigation was complete. Although tourniquet syndrome is a rare entity, early diagnosis and treatment is essential to avoid potentially severe complications.Downloads
References
Claudet I, Pasian N, Debuisson C, Salanne S, Rekhroukh H. Tourniquet syndrome: Interest of a systematic analysis of families’ social conditions to detect neglect situations. Child Abuse Negl 2009;33(9):569-72. https://doi.org/10.1016/j.chiabu.2009.03.003
Cevik Y, Kavalci C. Hair tourniquet syndrome. Ann Saudi Med 2010;30(5):416-7. https://doi.org/10.4103/0256-4947.67088
Uygur E, Çarkçi E, Ünkar E. Can washing socks without flipping inside out cause hair tourniquet syndrome? A claim with two case reports. J Pediatr Orthop B 2017;26(2):193-4. https://doi.org/10.1097/BPB.0000000000000348
García-Mata S, Hidalgo-Ovejero A. Hair tourniquet syndrome of the toe: report of 2 new cases. J Pediatr Orthop 2009;29(8):860-4. https://doi.org/10.1097/BPO.0b013e3181b7ff14
Quinn NJ Jr. Toe tourniquet syndrome. Pediatrics 1971;48(1):145-6. https://doi.org/10.1542/peds.48.1.145
Barton D, Sloan G, Nichter L, Reinisch JF. Hair-thread tourniquet syndrome. Pediatrics 1988;82:925-8.
PMID: 3186385
Dey R, Zameer MM, Vinay C, Rao, S. Hair tourniquet of the uvula. J Indian Assoc Pediatr Surg 2022;27(2):261-2. https://doi.org/10.4103/jiaps.JIAPS_365_20
Sylwestrzak MS, Fischer BF, Fischer H. Recurrent clitoral tourniquet syndrome. Pediatrics 2000;105(4 Pt 1):866-7. https://doi.org/10.1542/peds.105.4.866
Schneider K, Kennebeck S, Madden L, Campbell A. Hair tourniquet of the circumvallate papillae: a potentially “hairy” situation. Pediatr Emerg Care 2013;29(8):924-5. https://doi.org/10.1097/PEC.0b013e31829ec4c7
Haddad FS. Penile strangulation by human hair: report of 3 cases and review of literature. Urol Int 1982;37(6):375-88. https://doi.org/10.1159/000280843
Mat Saad AZ, Purcell EM, McCann JJ. Hair-thread tourniquet syndrome in an infant with bony erosion: a case report, literature review, and metaanalysis. Ann Plast Surg 2006;57(4):447-52. https://doi.org/10.1097/01.sap.0000222571.98387.71
Mackey S, Hettiaratchy S, Dickinson J. Hair-tourniquet syndrome-multiple toes and bilaterality. Eur J Emerg Med 2005;12(4):191-2. https://doi.org/10.1097/00063110-200508000-00009
Alpert JJ, Filler R, Glaser HH. Strangulation of an appendage by hair wrapping. N Engl J Med 1965;273(16):866-7. https://doi.org/10.1056/NEJM196510142731608
Parlak M, Karakaya AE. Hair-thread tourniquet syndrome of the hypertrophic clitoris in a 6-year-old girl. Pediatr Emerg Care 2015;31(5):363-4. https://doi.org/10.1097/PEC.0000000000000341
Corazza M, Carla E, Altieri E, Virgili A. What syndrome is this? Tourniquet syndrome. Pediatr Dermatol
;19(6):555-6. https://doi.org/10.1046/j.1525-1470.2002.00233.x
Strahlman RS. Toe tourniquet syndrome in association with maternal hair loss. Pediatrics 2003;111(3):685-7. https://doi.org/10.1542/peds.111.3.685
Martonovich N, Khatib M, Assaf M. Hair tourniquet syndrome: A retrospective study. Pediatr Dermatol 2022 Sep 30. https://doi.org/10.1111/pde.15151
Klusmann A, Lenard HG. Tourniquet syndrome-accident or abuse? Eur J Pediatr 2004;163(8):495-8; discussion 499. https://doi.org/10.1007/s00431-004-1466-1
Singh B, Kim H, Wax S. Strangulation of glans penis by hair. Urology 1978;11(2):170-2. https://doi.org/10.1016/0090-4295(78)90100-0
Thomas AJ, Timmonjs JW, Perlmutter AD. Progressive penile amputation tourniquet injury secondary to hair. Urology 1977;9(1):42-4. https://doi.org/10.1016/0090-4295(77)90282-5
Webley JA, Scheif DR, Coleman J. Tourniquet syndrome: an unusual presentation. Ann Emerg Med 1981;10(9):494-5. https://doi.org/10.1016/s0196-0644(81)80288-0
Serour F, Gorenstein A. Treatment of the toe tourniquet syndrome in infants. Pediatr Surg Int 2003;19(8):598-600. https://doi.org/10.1007/s00383-003-1034-1
Aslantürk O, Özbey R, Yılmaz Ö, Ergen E. Hair tourniquet syndrome of toes and fingers in infants. Acta Orthop Traumatol Turc 2019;53(4):306-9. https://doi.org/10.1016/j.aott.2019.04.010
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