The rubber band syndrome: the forgotten rubber band in the wrist

A linear constricting scar around the wrist in the presence of a discharging sinus raises clinical suspicion of a forgotten band around the wrist. A 3-year-old girl presented with an encircling scar, swelling and discharging sinus over the right wrist since last three months. There were no trophic ulcers and gross sensations were intact. Wrist radiographs showed the "constriction" sign in the radial epiphysis. MRI confirmed the diagnosis of encircling band inside wrist abutting the bone. A coloured rubber band was surgically extracted lying deep to restored and continuous tendons and neurovascular structures. Wound healing was uneventful. Examination at 14 months revealed residual ulnar nerve palsy. If aware, the clinical diagnosis is fairly accurate in rubber band syndrome. MRI aids in establishing diagnosis preoperatively. The reparative potential of a child's tissues is amazing. Although the lesion heals well after extraction of encircling band, the clinician should be wary of residual neurological changes.