Dhaga syndrome: a previously undescribed entity

A Arora1, A Agarwal

  • 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.

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