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Rubber band syndrome--high accuracy of clinical diagnosis
Aditya N Aggarwal1, Sunil Gurpur Kini, Anil Arora
1Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
Insights
Rubber band syndrome, a rare condition in children, occurs when a forgotten rubber band constricts wrist tissues, causing swelling and functional loss. Early recognition and surgical removal lead to good hand function recovery.
Area of Science:
- Pediatric Surgery
- Medical Case Reports
- Dermatology
Background:
- Rubber band syndrome is a rare pediatric condition caused by prolonged wearing of decorative rubber bands on the wrist.
- It can lead to tissue burrowing, distal edema, loss of function, and neurovascular compromise.
Observation:
- A case series of three children presenting with discharging sinus and linear circumferential scars on the wrist.
- Radiographs revealed soft tissue constriction, consistent with an embedded, forgotten rubber band.
Findings:
- Surgical removal of the embedded rubber band was successful in all three cases.
- Postoperative follow-up averaging 13 months showed excellent hand function recovery.
Implications:
- Clinicians should suspect rubber band syndrome in children with wrist constricting scars and discharging sinuses.
- Prompt diagnosis and surgical intervention are crucial to prevent long-term complications and ensure functional recovery.
Background:
Rubber band syndrome is a rare condition seen in younger children in communities where rubber bands are worn around the wrist for decorative purposes. When the band is worn for a long duration, it burrows through the skin and soft tissues resulting in distal edema, loss of function, and even damage to the neurovascular structures. Recognition of this syndrome at the earliest can prevent catastrophic events.
Methods:
We report 3 cases of rubber band syndrome. Three children presented with a discharging sinus at the wrist. There was a linear circumferential scar at the wrist in all cases. Plain radiographs showed a circumferential constriction in the soft tissue shadow in all the cases. There was a history of a band tied around the wrist, which had been forgotten by the parents and eventually became embedded in the soft tissues of the wrist.
Results:
Surgical removal of the buried rubber band was successful in all the cases. Postoperative follow-up over a mean period of 13 months have shown a surprisingly good outcome of hand function in all our patients.
Conclusions:
The cardinal features of a linear constricting scar around the wrist in the presence of a discharging sinus should always alert the clinician to the possibility of a forgotten band around the wrist, which might have burrowed into the soft tissues over a period of time. A radiograph of the affected wrist shows a soft tissue constriction at the wrist. A high index of clinical suspicion and the uniformity of symptoms and clinico-radiologic signs enabled us to make a clinical diagnosis of a constriction band (rubber band syndrome), which was proved after a surgical exploration.
Study Design:
Case series. Level of Evidence--Level IV.
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