MPS  Vol.2 No.1 , January 2012
Commonly Misdiagnosed Rare Condition – Toe Tourniquet Syndrome – Literature Review
Abstract: Toe Tourniquet Syndrome (TTS) is a rare yet potentially devastating, acquired defect, which is repeatedly misdiagnosed in the United Kingdom and abroad. Due to the relatively infrequent presentation, it can be easily missed. Toe tourniquet syndrome is strangulation of the toes by what is usually hair, although synthetic fibres have also been described. It is considered a surgical emergency as left untreated, the tissues of the toe can become necrotic and the patient would lose that appendage. In this paper, we have done a literature review and written the article with illustrations which would explain this repeatedly misdiagnosed condition very thoroughly to all the clinicians dealing with this rare problem.
Cite this paper: M. Hussain, T. Taneerananon and S. Wharton, "Commonly Misdiagnosed Rare Condition – Toe Tourniquet Syndrome – Literature Review," Modern Plastic Surgery, Vol. 2 No. 1, 2012, pp. 8-11. doi: 10.4236/mps.2012.21003.

[1]   J. D. Barton, G. M. Sloan, L. S. Nichter and D. J. Reinisch, “Hair-Thread Tourniquet Syndrome,” Pediatrics, Vol. 82, No. 6, 1988, pp. 925-928.

[2]   R. R. Miller, W. E. Baker and G. H. Brandeis, “Hair-Thread Tourniquet Syndrome in a Cognitively Impaired Nursing Home Resident,” Advances in Skin & Wound Care, Vol. 17, No. 7, 2004, pp. 351-352. doi:10.1097/00129334-200409000-00014

[3]   R. S. Strahlman, “Toe Tourniquet Syndrome in Association with Maternal Hair Loss,” Pediatrics, Vol. 11, 2002, pp. 685-687.

[4]   S. Mackey, S. Hettiaratchy and J. Dickinson, “Hair- Tourniquet Syndrome—Multiple Toes and Bilaterality,” European Journal of Emergency Medicine, Vol. 12, No. 4, 2005, pp. 191-192. doi:10.1097/00063110-200508000-00009

[5]   J. J. Alpert, R. Filler and H. H. Glaser, “Strangulation of an Appendage by Hair Wrapping,” New England Journal of Medicine, Vol. 273, 1965, pp. 866-867. doi:10.1056/NEJM196510142731608

[6]   J. H. Kuo, L. M. Smith and C. D. Berkowitz, “A Hair Tourniquet Resulting in Strangulation and Amputation of the Clitoris,” Obstetrics and Gynecology, Vol. 99, No. 5, 2002, pp. 939-941. doi:10.1016/S0029-7844(01)01753-7

[7]   I. Claudet, N. Pasian, C. Debuisson, S. Salanne and H. Rekhroukh, “Tourniquet Syndrome: Interest of a Systematic Analysis of Families’ Social Conditions to Detect Neglect Situations,” Child Abuse and Neglect, Vol. 33, No. 9, 2008, pp. 569-572. doi:10.1016/j.chiabu.2009.03.003

[8]   S. Garcia-Mata and A. Hidalgo-Overjero, “Hair Tourniquet Syndrome of the Toe: Report of 2 New Cases,” Journal of Pediatric Orthopaedics, Vol. 29, No. 8, 2009, pp. 860-864. doi:10.1097/BPO.0b013e3181b7ff14

[9]   D. D. Douglas, “Dissolving Hair Wrapped around an Infant’s Digit,” Journal of Pediatrics, Vol. 91, 2003, 1977, p. 162.

[10]   F. Serour and A. Gorenstein, “Treatment of the Toe Tourniquet Syndrome in Infants,” Pediatric Surgery International, Vol. 19, No. 8, 2003, pp. 598-600. doi:10.1007/s00383-003-1034-1

[11]   S. T. Sudhan, S. Gupta and C. Plutarco, “Toe-Tourniquet Syndrome—Accidental or Intentional?” European Journal of Pediatrics, Vol. 159, No. 11, 2000, pp. 866-874. doi:10.1007/PL00008357

[12]   R. A. Haene and M. Loeffler, “Hair Tourniquet Syndrome in an Infant,” The Journal of Bone & Joint Surgery, Vol. 89-B, 2007, pp. 244-245.

[13]   R. Y. Liow, P. Budny and P. J. Regan, “Hair Thread Tourniquet Syndrome,” Journal of Accident & Emergency Medicine, Vol. 13, No. 2, 1996, pp. 138-139. doi:10.1136/emj.13.2.138

[14]   J. W. Mack, R. M. Takamoto, F. R. Jones, et al., “Toe Tourniquet Syndrome,” The Western Journal of Medicine, Vol. 125, 1976, pp. 335-336.

[15]   P. Lohana, G. N. Vashishta and N. Price, “Toe-Tourniquet Syndrome: A Diagnostic Dilemma!” Annals of The Royal College of Surgeons of England, Vol. 88, No. 4, 2006, pp. 6-8.

[16]   F. S. Haddad, “Penile Strangulation by Human Hair. Report of Three Cases and Review of the Literature,” Urologia Internationalis, Vol. 37, No. 6, 1982, pp. 375-388.

[17]   A. Klusmann and H. G. Lenard, “Tourniquet Syndrome—Accident or Abuse?” European Journal of Pediatrics, Vol. 163, 2004, pp. 495-498.