Strangulation of appendages by hair and thread

Abstract

This series of cases of strangulation of appendages is reported to call attention to a frequently unrecognized entity, to emphasize its importance, and to recommend a simple method of treatment. The study includes a review of the limited number of cases of strangulation of appendages reported in the literature, as well as a presentation and discussion of cases encountered in the authors' practices. In 1965 Alpert et al., 1 reported three cases of strangulation of an appendage by hair wrapping, and emphasized that because of the physical characteristics of human hair, its presence as a foreign body may not be recognized and diagnosis may be missed. In 1966, Curran 2 described a case suggesting intentional encirclement of toes by hair, and Feinberg 3 emphasized the significance of interdigital friction burns caused by loose elastic protruding into the lumen of an infant's pajama bootees. Quinn 4 in 1971 labeled this condition as the “toe tourniquet syndrome,” pointing out that loose threads from leotard-type garments inadvertently may become wrapped about a child's toes, and he warned both parents and the garment industry to be aware of this condition. As delay in recognition and institution of proper treatment of this problem can result in loss of part or all of an appendage, it was felt that a clinical review of ten cases seen in the past 3 yr at the St. Joseph Mercy Hospital in Ann Arbor, Mich., would be beneficial.