Hair Tourniquet Research Articles

A CASE OF HAIR THREAD TOURNIQUET SYNDROME OF THE TOE IN A MALE NEWBORN

Hair-thread Tourniquet Syndrome (HTTS), despite being widely reported, is often not well recognized. It is a rare surgical emergency. This syndrome involves the external, mechanical, circumferential constriction of an appendage by human hair, typically a digit, leading to a condition similar to compartment syndrome. If not treated promptly, it can lead to prolonged ischemia, potentially causing tissue necrosis or autoamputation of the affected digit. Herein, we report a four-day-old newborn from a low socioeconomic background was admitted with fever and feeding refusal. Clinical examination revealed a swollen and red big 4thtoe with a hair-thread tourniquet. No signs of toe ischemia were noted. A diagnosis of maternal-fetal infection with a meningeal focus was made, along with toe tourniquet syndrome. Radiography showed no bone lesion. The patient was treated with antibiotics and a healing cream.

Delayed Diagnosis of Labial Hair Thread Tourniquet Syndrome in a Postmenarchal Adolescent: A Case Report

BackgroundHair thread tourniquet syndrome occurs when tissue is strangulated by a hair thread. It occurs most commonly in the digits of infants and young children, but can also occur in the genitalia. Case ReportA 13-year-old postmenarchal girl with several days of severe vulvar pain and swelling presented to the emergency department. Diagnosis was unclear and she was referred to pediatric and adolescent gynecology. Pelvic examination under anesthesia revealed a hair thread tourniquet involving the bilateral labia minora. The hair tourniquet and portions of bilateral labia minora were excised. Why Should an Emergency Physician Be Aware of This? Genital hair thread tourniquet syndrome is uncommon but must be considered in patients with severe genital pain and swelling. Prompt diagnosis and treatment are important to prevent tissue necrosis and may be facilitated by means of a pelvic examination with sedation.

Foot & Ankle

The February 2024 Foot & Ankle Roundup360 looks at: Survival of revision ankle arthroplasty; Tibiotalocalcaneal nail for the management of open ankle fractures in the elderly patient; Accuracy of a patient-specific total ankle arthroplasty instrumentation; Fusion after failed primary ankle arthroplasty: can it work?; Treatment options for osteochondral lesions of the talus; Managing hair tourniquet syndrome of toe: a rare emergency; Ultrasound-guided collagenase therapy for recurrent plantar fibromatosis: a promising line of therapy?.

Successful management of near-total penile amputation secondary to neglected hair tourniquet syndrome

Successful management of near-total penile amputation secondary to neglected hair tourniquet syndrome

Diagnosis and Treatment of a Nonhealing Wound Secondary to a Reepithelialized Hair Tourniquet With Ultrasound.

A 9-month-old girl presented with a chronic wound on the dorsal surface of her toe that failed 6 months of medical management. Due to the prolonged clinical course, there was a concern for a foreign body. Intraoperative ultrasound was utilized to identify linear echogenic structures, which were excised and consistent with reepithelialized hairs secondary to hair-thread tourniquet syndrome. There were also erosive changes to the underlying phalanx. Intraoperative ultrasound was also used to guide the incision size and confirm the complete removal of the hairs.

Hair Tourniquet of Penis in a Male Goat

An infrequent case of hair tourniquet of the penis in a male goat aged two years with a history of difficulty in urination is reported here.

Progressive Coil Penile Tourniquet Syndrome: Single Center Experience with 26 Cases at Department of Pediatric Urology at the Institute of Kidney Diseases MTI Hayatabad Peshawar

Objective: This study was conducted to know the causes of penile tourniquet injury, its complications and awareness about the condition to prevent its devastating outcomes. Methods: this study was completed in five year (2017-2022) at Institute of Kidney Diseases MTI Hayatabad Peshawar. The injuries were graded ‘as described by Bashir and El-Barbary. Results: this study is composed of 26 Patients. . The mean age of patients was noted seven years (6.93years) with range 2.3years to 11years. Human hair was found constricting agent (09 patients). All of the patients were circumcised. In most patients a delay in diagnosis of more than five weeks was noted. Conclusion: Penile tourniquet injury in children can cause devastating range of injuries from mild glans edema to penile amputation. The knowledge of such conditions/injuries can easily diagnose the condition and prevent its complications.

Hair tourniquet syndrome: A retrospective study.

Hair thread tourniquet syndrome (HTS) is a pediatric condition in which human hair or synthetic fiber encircles and strangulates a body appendage causing tissue necrosis. Few epidemiologic studies have been done. Our objective was to better define the demographics, clinical features, and predisposing factors for this condition. Medical records of all infants up to 1 year old seen in the orthopedic emergency department of Galilee Medical Center were searched for the diagnosis of HTS or its ICD equivalent. Forty-one cases of hair tourniquet syndrome (HTS) were reviewed. Most cases (68%) occurred during the winter months (December to February). There were no reports between June to August (summer). The median age was 4months and the male-to-female ratio was approximately 2:5. Toes were significantly more involved than fingers (97.5%) and the 3rd toe was the most affected (58%). Nine patients (21.9%) had more than one toe affected and only one case reported finger involvement. HTS in our population is a phenomenon that seems to occur mostly in winter. Infants between 3 and 5months are at greater risk. Toes are more affected than fingers. The most involved toes are the 3rd and 4th.

The First Report of Isolated Clitoral Hood Hair-Thread Tourniquet Syndrome: A Study of Six Patients.

Background and objectiveHair-thread tourniquet syndrome (HTTS) is a rare and potentially dangerous condition that occurs when a hair strand or fabric thread is wrapped around the penis, clitoris, toes, fingers, or other appendages, leading to focal edema, ischemia, and necrosis. This study aimed to examine the cases of six female patients with isolated clitoral hood HTTS.MethodsThis was a retrospective study involving six female patients (age range: two to six years) with isolated clitoral hood tourniquet who presented to the outpatient department (OPD) and emergency room (ER) of the pediatric and adolescent gynecology service at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 2010 and December 2021. Data related to patients’ clinical presentation, symptom duration, and management were recorded.ResultsThe most common symptom of isolated clitoral hood HTTS in all six cases was pain, followed by redness, itching, discomfort while sitting, and dysuria. Local signs included edema in three cases, tight hair tourniquet around a portion of the clitoral hood in four cases, and loose hair tourniquet around a portion of the clitoral hood in two cases, one of which was during the first episode in a patient who had recurrence (Case 1). Sedation and local anesthetic were used in five cases involving the local removal of four hairs and a strangulated skin. This was followed by local care and antibiotic ointment application. The edges were closed by interrupted stitches in two of the cases as the resulting wounds were broad. Limited clitoral unhooding was performed under general anesthesia in one patient, who had repeated bouts of autoamputation of parts of the hood tissue with resulting disfiguration of the remaining redundant hood, to avoid the additional risk of organ loss. Only two patients experienced recurring episodes.ConclusionsA high index of suspicion should be maintained when encountering these patients, which can facilitate a prompt resolution to save the affected tissue. HTTS should be suspected in all females presenting with a prominent clitoral hood, genital pain, structural abnormality, swelling, or discomfort. This is the first study to report isolated clitoral hood HTTS; it describes the presentation, manifestation, and management of patients with HTTS. It also addresses preventive strategies to alert mothers and treating physicians of the pediatric and adolescent-age group females to the defect and its underlying causes, particularly when patients have genital structural abnormalities such as excessive clitoral hood labial hypertrophy or ambiguous genitalia.

Infantile penile degloving injury secondary to hair tourniquet

Penile degloving injuries are rare, usually involve traumatic forces, and are minimally reported in the medical literature. Whereas penile degloving typically results from obvious traumatic injuries, this case report presents a two-week-old uncircumcised infant presenting to the emergency room with a penile degloving injury due to hair tourniquet syndrome that was not initially apparent. Hair tourniquets, more commonly seen in infants on digits, can lead to devascularization and necrosis of the injured tissue which in this case resulted in a degloving injury. This presentation of a hair tourniquet on an uncircumcised infant causing degloving is uncommon and provides an expanded differential diagnoses in childhood penile injuries.

Hair Tourniquet around Labia Majora: A Case Report and Literature Review

Hair tourniquet syndrome (HTS) is a condition where the hair or thread wrapped around part of the body accidently. Commonly found around the toe but it can occasionally be found around the fingers, external genitalia and anywhere else. Here in our case we want to mention the importance of proper exam of the genitalia especially if the patient has chronic pain and tenderness at the genital area to exclude hair tourniquet as one of the differential diagnosis.

Hair tourniquet syndrome of labia minora: case report.

Hair Tourniquet Syndrome (HTS) is defined as strangulation by a hair thread of the appendage of the human body, especially in the children population, it rarely occurs in external genitalia (clitoris, labia majora and minora). Herein, we aimed to present a rare occurrence of HTS around the labia minora in a 12-year-old child treated by excision of the cystic lesion with an uneventful follow-up. Special care should be given to every swollen appendage in children to avoid severe consequences such as amputation and disfigurement.

Near strangulation caused by hair tourniquet syndrome involving mother's hair.

Near strangulation caused by hair tourniquet syndrome involving mother's hair.

Evaluation of Depilatory Agents in the Treatment of Hair-Thread Tourniquet Syndrome.

This review aims to evaluate the effectiveness, benefits, complications, and contraindications of depilatory agents in HTTS. Relevant terms to HTTS and depilatory agents were used to search for articles on MEDLINE and EMBASE databases using the NHS Healthcare Databases Advanced Search engine. In total, 19 of the 295 articles identified in the primary search were included in the final review. Articles described the benefits of depilatory agents as painless, well tolerated, and non-invasive. Contraindications described include use on mucosal membranes, non-hair tourniquet, and allergy. Sixty-four percent (n=55) of patients had resolution of their HTTS after one or two cycles of depilatory agent treatment. The use of depilatory agents has multiple potential benefits. The authors propose a treatment algorithm for the use of depilatory agents in HTTS and recommend that all acute centers should store and train staff in their use.

38. Painless Labia Hair Tourniquet Presenting as a Recurrent Vulvar Mass

<h3>Background</h3> Hair tourniquets are a rare phenomenon effecting potentially any appendage. Male genitalia and digits are the most common locations with female genitalia classified as an "other" site, occurring in less than 6% of reported reviews. The most recent review of female genital hair tourniquets identified 34 patients from 32 reports or series. Pain was reported as a presenting symptom in 30 cases, while the remaining four cases did not comment on pain. We present a case of an asymptomatic labial hair tourniquet presenting as a vulvar mass. <h3>Case</h3> The patient is a 5-year 7-month female born at 24 weeks gestation with intraventricular hemorrhage and subsequent cerebral palsy (CP) and lower extremity contractures. The patient was referred by her PCP for possible biopsy due to a recurrent vulvar mass that waxed and waned in size and purple discoloration over two months. The patient was scheduled for exam under anesthesia and noted to have an edematous left labia minora (Fig 1) with tightly wound hair and cotton threads at the base leaving an erosion with an indentation flap in its mid portion (Fig 2). The fibers were released, a ‘V" excision was created removing the mid portion (Fig3), and the inferior and superior areas of the labia were approximated restoring symmetry. (Figs 4) The patient's postoperative course was uncomplicated and at 20 months post procedure her parents report normal anatomy without new incidents of labia edema. <h3>Comments</h3> This case report demonstrates a presentation of chronic painless swelling due to a labia hair tourniquet, which has not yet been described in the literature. Absence of pain may have led to a delay in referral for definitive diagnosis and treatment. It is possible that sensory disruptions in the lower extremities from CP contributed to the lack pain perception by the patient.

35. Asymmetric Labial Hypertrophy in an Adolescent with History of Prepubertal Straddle Injury

<h3>Background</h3> Long term follow up of straddle injuries (SI) in prepubertal females is not well documented in current literature. It is unclear how these patients should be counseled about how prepubertal SI could affect pubertal development of genital structures. We present a case of post pubertal asymmetric right labial hypertrophy in a patient with prepubertal SI. <h3>Case</h3> Our patient initially presented at 8 years old (YO) to our emergency department (ED) after sustaining a SI from falling on a playground beam. Evaluation in the ED showed a hemostatic shallow right labial laceration at 9 o'clock. Repair was not indicated and she was discharged home. Follow up in the office 2 weeks later showed the area had healed well, no anatomic abnormalities noted. At 13 YO, she presented to the office for evaluation of abnormal right labia minora (LM), discovered after getting a hair tourniquet on the area. At her visit, she reported normal pubertal development and menarche at 12 YO. In addition to the hair tourniquet, she reported the area of abnormal tissue was causing discomfort, frequently catching on underwear and clothes. On physical exam, she was noted to have Tanner stage IV pubic hair. The bilateral labia majora were normal and symmetric. The left LM was normal in shape and appearance, and approximately 1 cm in length. The right LM was abnormal, having a pedunculated length of tissue measuring 6 cm in length and 1 cm in width, with the base of the LM extending from the clitoral hood to approximately 9 o'clock, below which there was no identifiable LM tissue. There was no visible scar in the area of her prior SI, however that was the location where the right LM tissue ended. The patient and her parents elected for surgical correction of the abnormal area. She underwent right labiaplasty, and the excess pedunculated right LM tissue was removed without complications. On post operative follow up, the area was well healed. <h3>Comments</h3> Most studies on prepubertal SI only include short term follow up, typically until healing of the injury has occurred. There is a paucity of data regarding long term outcomes. Though most SI are minor and will likely have no long term effect, our case demonstrates how even a seemingly minor prepubertal SI with no visible scarring in the area can lead to abnormal development of the genitalia with puberty.

Isolated penile injury in boys: Accident, negligence, or abuse?

Aim:The aim of the study was to highlight the etiology, spectrum of presentation, and management of isolated penile trauma in boys.Methods:A retrospective review of boys treated for isolated penile trauma between January 2015 and June 2019 at a tertiary-level hospital.Results:Nine children were admitted over 4½ years. Etiology: The mechanism of penile injury (PI) was penile hair tourniquet (n = 5), postcircumcision (n = 2), dog bite (n = 1), and scald injury (n = 1). Extent of injury includes complete urethral transection at corona (n = 4); loss of urethral plate in a case of hypospadias (n = 1); complete loss of glans (n = 1); penile transection at corona (n = 1); total penile amputation (n = 1); and deep partial-thickness burns of penile shaft and adjacent suprapubic skin (n = 1). Management: One patient absconded. The remaining patients were managed as follows: calibration of urethral meatus (n = 1); penile burn was managed with dressing and antibiotics; coring of glans with urethral end–end anastomoses (n = 4); Bettocchi's quadrangular lower abdominal flap phalloplasty (n = 1); and Bracka's staged urethroplasty (n = 1). Complications include wound infection following trauma (n = 4), postsurgical infection (n = 3), urethrocutaneous fistula (n = 2), and reapplication of penile hair tourniquet (n = 1).Conclusion:Isolated PI in boys is not uncommon. Most are preventable if the parents are apprized and watchful. The clinician should also be vigilant regarding child maltreatment. A staged approach tailored to the type of injury provides a satisfactory outcome.

Hair Tourniquet Syndrome in a two-month-old infant

症例：0 歳 2 カ月，男児主訴：右第 2 趾の腫脹

Removal of a Steel Ring Causing Penile Strangulation Without the Use of Powered Tools or Sharp Blades

Penile strangulation is an uncommon urologic emergency that requires prompt evaluation and treatment to avoid disastrous consequences. Strangulation has been reported with objects ranging from hair tourniquets, to plastic rings, to iron rings. Strangulation with these devices can result in vascular congestion of the penis, swelling and eventual gangrene of the penis distal to the constricting device. We present a case report of a 43-year-old male who had a 2-day history of penile pain and swelling secondary to a metal ring constricting the proximal phallus. Ring removal was achieved with an orthopedic bolt cutter to cut the ring in two places, using a malleable retractor to act as a “backboard” to prevent iatrogenic injury to the penis.

Uvula Strangulation: A Rare Case of Hair Thread Tourniquet Syndrome

Hair thread tourniquet syndrome is a rare but previously well-documented presentation. It is described as circumferential strangulation of distal or multiple distal appendages, which can lead to tissue ischaemia and eventually necrosis without prompt treatment. Despite the characteristic presentation and potential for serious complications, many healthcare professionals remain unaware of hair tourniquet syndrome and the need for urgent management. We present the case of a 9-month-old infant who presented to the emergency department. The parent noted a long hair emanating from the mouth but on attempts to remove it was unable to do so. The child was otherwise stable. Examination on the oral cavity revealed the hair strand tightly wrapped around an oedematous and congested uvula. Attempts to remove the ligature in the emergency department were unsuccessful and a subsequent referral to otolaryngology was made. A decision was made to take the child to the operating theatre, where the ligature was successfully removed with the distal uvula remaining viable.