title: Rubber band syndrome--high accuracy of clinical diagnosis.
abstract: 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.
  
  
  METHODS
  Case series. Level of Evidence--Level IV.
authors.affiliation: Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
authors.forename: Aditya N
authors.initials: AN
authors.lastname: Aggarwal
authors.forename: Sunil Gurpur
authors.initials: SG
authors.lastname: Kini
authors.forename: Anil
authors.initials: A
authors.lastname: Arora
authors.forename: Arun Pal
authors.initials: AP
authors.lastname: Singh
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Gupta
authors.forename: Divesh
authors.initials: D
authors.lastname: Gulati
mesh_terms: D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D004487:Edema / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000601:surgery*; D006225:Hand; D006801:Humans; D007223:Infant; D008297:Male; D020127:Recovery of Function; D012408:Rubber; D013577:Syndrome; D013997:Time Factors; D014953:Wrist
chemical_list: D012408:Rubber