Hair-tourniquet syndrome--multiple toes and bilaterality

The hair-tourniquet syndrome involves circumferential strangulation of an appendage by a human hair or fibre and usually affects infants under the age of 2. It is an emergency condition that induces progressive oedema, ischaemia and tissue necrosis and can lead to the autoamputation of digits or other strangulated structures. Though the majority of cases are accidental, a proportion may be due to nonaccidental injury. The prompt diagnosis and treatment of the condition is vital to attain a good outcome and prevent further harm to the child. We report a case of hair-tourniquet syndrome affecting multiple toes of an infant, and suggest that awareness of the condition should be increased to help prevent its potential complications.