EC Paediatrics

Toe-tourniquet syndrome is a condition caused by hair or fibrous strands encircling a digit. It can lead to compressive oedema, ischaemia and potential loss of an appendage. The condition constitutes a surgical emergency requiring immediate intervention. We report a 23+5 weeks gestation infant weighing 545 grams at birth who was admitted to a tertiary neonatal unit for medical management of respiratory distress syndrome. The infant developed toe-tourniquet syndrome on day 18 after birth. This complication presented as ischaemic swelling of the second and third toes of one limb with the constricting fibres arising from the infant’s wool blanket. Restoration of the infant’s toes circulation and full recovery was achieved after manual removal of the bands. We would like to raise awareness of this condition which has not been described in extremely preterm infants previously. This is to prevent potential complications relating to wool blankets which are commonly used in neonatal units.

Keywords: Prematurity; Toe; Tourniquet; Syndrome

1. Alpert , et al. “Strangulation of an appendage by hair wrapping”. New England Journal of Medicine 273.16 (1965): 866-867.
2. Quinn “Toe tourniquet syndrome”. Pediatrics 48.1 (1971): 145-146.
3. Garcia-Mata S and Hidalgo-Overjero “Hair tourniquet syndrome of the Toe: Report of 2 new cases”. Journal of Pediatric Orthopedics 29.8 (2009): 860-864.
4. Alruwaili , et al. “Hair tourniquet syndrome: Successful management with a painless technique”. International Journal of Pediatrics and Adolescent Medicine 2.1 (2015): 34-37.
5. Baştuğ , et al. “Hair-thread tourniquet syndrome in a preterm baby”. Turkish Archives of Pediatrics 50.4 (2015): 245-247.