Small Hairs Make Big Cuts (and Consequences)

​The hair or thread tourniquet syndrome is a relatively rare condition that has evaded me in the emergency department for several decades, until past year when three cases showed up over six months. This condition has been around for as long as there has been hair or thread and body appendages. In fact, this condition may have first been described in the 1600s. (J Pediatr Adolesc Gynecol 2005;18[3]:155.)The etiology of this condition seems almost unbelievable. How in the world does a hair get wrapped repeatedly and tightly around an appendage of the body? Some authors expressed the need to consider nonaccidental etiologies more frequently. Stranger things, however, have happened in emergency medicine (e.g., the urinary catheter tying itself in a knot in the bladder of a patient). (APSP J Case Rep 2011;2[3]:21; J Clin Ultrasound 2009;37[6]:360.)The risks of strangulation and autoamputation of the involved appendage are very real. This condition does not respect age, gender, or appendage. Hair tourniquets of the penis, clitoris, labia minora, teeth, uvula, fingers, toes, and even the larger extremities have been reported in the young and the elderly. They are, however, much more common in infants and young children than they are in adolescents or adults. In fact, a fascinating temporal association has been made between hair tourniquets and the mother's postnatal telogen effluvium, which causes significant maternal hair loss months after the infant's delivery. Cons...
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