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Dhaga syndrome: a previously undescribed entity
1Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
Insights
Forgotten sacred threads (Moli Dhaga) caused wrist sinus infections in three young children. Surgical removal of the embedded threads successfully treated the condition, highlighting a rare cause of pediatric wrist issues.
Area of Science:
- Pediatric surgery
- Orthopedics
- Medical case reports
Background:
- Foreign body retention is a common cause of pediatric injury.
- The Moli Dhaga, a sacred thread, is sometimes tied around children's wrists in certain cultural practices.
- Forgotten threads can become embedded, leading to complications.
Observation:
- Three children aged 18 months to 4 years presented with discharging wrist sinuses.
- The sinuses were caused by forgotten Moli Dhaga threads embedded in the soft tissues.
- Radiographs revealed circumferential soft tissue constriction and, in two cases, a periosteal reaction with indentation (constriction sign).
Findings:
- The Moli Dhaga thread, when forgotten and embedded, can cause chronic sinus tracts in pediatric wrists.
- Radiographic findings include soft tissue constriction and a characteristic 'constriction sign' indicative of the embedded foreign body.
- Surgical intervention for the removal of the embedded thread was curative in all reported cases.
Implications:
- This case series highlights an unusual cause of pediatric wrist infections and sinus formation.
- Early recognition and surgical management are crucial for favorable outcomes.
- The 'constriction sign' on radiographs may aid in diagnosing embedded foreign bodies in pediatric extremities.
Abstract:
Three children between the ages of 18 months and four years presented with a discharging sinus or sinuses at the wrist due to a 'sacred' thread (the Moli Dhaga) which had been tied around it. This thread had been forgotten by the parents and had become embedded in the soft tissues of the wrist. Plain radiographs showed a circumferential constriction in the soft tissue shadow in all three. In two, there was a periosteal reaction in the distal radius or ulna with an indentation which we have called the constriction sign. Surgical removal of the buried thread was successful in all cases.
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