A Case of Hair Thread Torniquet Syndrome in a Neonate - Unusual Hand Injury Caused by Mittens

Rabindran chandran, Hemant Parakh


Hand injury secondary to mittens application have been reported since 1960s. A neonate was brought with history of bilateral hand swelling with dusky discoloration predominantly involving the right hand. Two mittens were worn in both hands and tightened at the wrist by elastic bands. Discoloration of the right hand with constriction mark at the wrist was noted. Hair thread tourniquet syndrome was suspected which is caused by hair or synthetic strands tightly wrapped around appendages.The underlying pathophysiology is impedance of lymphatic flow, venous outflow and/or arterial inflow obstruction. Treatment is prompt removal of the constricting substance with supportive care.

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Mann TP. Fingertip necrosis in the newly born: a hazard of wearing mittens. Br Med J. 1961(2):1755-1756.

Barton DJ, Sloan GM, Nichter LS. Hairthread tourniquet syndrome. Pediatrics. 1988 Dec;82(6):925-8.

Scott Strahlman R. Toe tourniquet syndrome in association with maternal hair loss. Pediatrics. Vol. 111 No. 3 March 1, 2003 pp. 685 -687.

Mack JW, Takamoto RM, Jones FR. Toe tourniquet syndrome. West J Med. Oct 1976; 125(4): 335–336.

Bower BD, Woodward J. Babies mittens. Br Med J. 1962 Jan 27;1(5273):a256–256.

MacLean H. Babies mittens. Br Med J. 1962Jan 27;1(5273):a256–256.

Long M. Gangrene in babies fingers. Nurs Times. 1965 Oct 22;61(43):1436-7.

Noott GG. Hazard from nylon. Br Med J. 1967 Aug 05;3(5561):e370–370.

Chan MCK, Wong TT. Injury caused by wearing mittens. Lancet. Volume 300, Issue 7788, Page 1206, 2 December 1972.

Hack M, Brish M. A finger equivalent of the toe tourniquet syndrome.Pediatrics. 1972 Aug;50(2):348-9.

Tulloch AL. Gangrene of the digits of an infant caused by nylon mittens. Med J Aust. 1973 Sep 8;2(10):501-2.

Matthews MG. Autoamputation of infant's finger by knitted mitten: a forgotten hazard. Br Med J. Apr 26, 1986; 292(6528): 1107.

Stringer MD, Seymour P. Finger injuries from infant mittens: a continuing but preventable hazard Injury. 1996 Apr;27(3):157-8.

Vandor T. Gangrene caused by woolen mitten. Can Med Assoc J. Apr 23, 1977; 116(8): 843.

Rork PE, Moore DR, Bagg RJ. Gangrene of a fingertip from a mitten thread ;JAMA. 1982;248(8):924-925..

Sun, Kelvin Kin-Wai, Choi, Kai-Yiu, Chow, Yuk-Yin. Injury by Mittens in Neonates: a report of an unusual presentation of this easily overlooked problem and literature review. Pediatric emergency care issue: 2007 - Volume 23 - Issue 10. pp: 681-769.


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