Hair tourniquet

  Hair tourniquet is a medical condition where in a hair or other thread becomes tied around a toe or finger tightly, so as to put the digit at risk of damage. Occasionally this is known as Toe tourniquet.

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The problem usually arises in babies and small children when hairs and thread are lost loosely inside socks. They can become spontaneously tied round a toe and will tend to tighten with wriggling. Natural hair is much more likely to undergo this phenomenon than spun thread.

Very rarely this condition can be induced deliberately as child abuse.

It is a counter-intuitive condition, which many would not believe could happen in reality.

Signs

As this is a condition primarily of young children, symptoms are rarely reported. The child will become suddenly uncomfortable and miserable. As the digit is often inside a sock, the cause may not be clear.

The affected toe can no longer receive an adequate blood supply via the arteries, nor can blood be drained via the veins. The toe will therefore swell and turn blue. This is ischaemia/ischemia.

The ligature will not stretch in response to the toe swelling and will therefore cut into the skin in more severe cases, like a cheese-wire.

Treatment

The ligature must be cut as quickly as possible. Often it is possible to lift a portion of it to enable cutting, but in a severe case the ligature must be cut through the skin. This is, of course, injurious to the child, but does prevent loss of the digit. It must take place on the side of the toe, where there are no nerves or tendons.

Outcome

Despite the distressing nature of the condition, outcomes are excellent. Loss of the toe is extremely rare, as is any residual disability.