Meier Rahel, Haug Luzian, Surke Carsten, Mathys Lukas, Vögelin Esther
Department of Handsurgery, Kantonsspital Baselland, Bruderholz, Switzerland.
Pediatr Emerg Care. 2019 Jun;35(6):e113-e115. doi: 10.1097/PEC.0000000000000992.
Rubber band syndrome is a rare entity seen in younger children mainly 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. These symptoms are difficult to relate to this rare but typical condition. We report a case of a 2¾-year-old girl with the history of a linear circumferential scar at the right wrist combined with the limited use of a swollen hand for several weeks. The child was taken to surgery with the purpose to release the red, indurated scar and eliminate the lymphatic congestion. A rubber band was found lying in a plane superficial to the flexor tendons but had cut through the superficial branch of the radial nerve and partially through the abductor pollicis longus tendon. The band was removed and the lacerated structures were repaired. The child had excellent recovery postoperatively. The cardinal features of a linear constricting scar around the wrist in the presence of a swollen hand should always alert the clinician to the possibility of a forgotten band around the wrist, which might have burrowed into the soft tissues for a period. Early recognition may be important to prevent further damage of essential structures.
橡皮筋综合征是一种罕见病症，主要见于年幼患儿，多见于有在手腕佩戴橡皮筋作装饰用途的社区。当橡皮筋长时间佩戴时，它会钻入皮肤和软组织，导致远端水肿、功能丧失，甚至损害神经血管结构。这些症状很难与这种罕见但典型的病症联系起来。我们报告一例2岁9个月大的女童，其右手腕有一条环形线状瘢痕，且手部肿胀伴活动受限数周。该患儿接受了手术，目的是松解发红、硬结的瘢痕并消除淋巴充血。术中发现一条橡皮筋位于屈肌腱浅面的平面，但已切断桡神经浅支并部分切断拇长展肌腱。取出橡皮筋并修复受损结构。患儿术后恢复良好。手腕部出现线性缩窄瘢痕且手部肿胀的主要特征应始终提醒临床医生注意手腕部可能存在被遗忘的橡皮筋，它可能已钻入软组织一段时间。早期识别对于防止重要结构进一步受损可能很重要。
