Hair tourniquet syndrome of the toe: report of 2 new cases.

Abstract

This report describes 2 new cases of toe tourniquet syndrome without accompanying signs of irritability. They were an 18-month-old girl and a 5-month-old boy suffering from strangulation of the third toe. The period of evolution was 20 days and 5 weeks. The toe worsened, with more extensive reddening and swelling, and deepening of the circular groove. Since a hair tourniquet was suspected, attempts were made to grasp the fiber with small-sized, blunt, and hook-shaped instruments, and mosquito clamp, with no success. The strand of hair compressing the toe lay deeper than expected. As improvement was barely noticeable, 2 dorsal paratendinous incisions were made and the hairs were extracted. Our aim is to raise awareness in the pediatric orthopaedic community of the existence of this syndrome, with a view to promoting the earliest possible diagnosis and appropriate management. In case of impossibility of removing the hairs we propose performing 2 dorsal paratendinous incisions, deep to the bone, to release completely the strangulation.