John Rakesh, Khurana Ankit, Raj Nirmal G, Aggarwal Pradeep, Kanojia Ravi, Chayapathi Varsha
Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India.
Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
J Clin Orthop Trauma. 2019 Jul-Aug;10(4):822-827. doi: 10.1016/j.jcot.2018.04.014. Epub 2018 Apr 23.
Once an exceedingly rare entity, multiple cases of forgotten rubber band syndrome or the so-called 'dhaaga' syndrome have now been reported in the literature.
To conduct a thorough and systematic review of the literature for all articles reporting a chronic type of rubber band syndrome and to present an additional similar case as an illustration.
Systematic review and case report.
PubMed, EMBASE and Google Scholar databases were searched for relevant articles using different combinations of the keywords till 20 June 2017. All articles reporting cases of chronic rubber band syndrome with a discharging sinus were included. Pearling of the bibliographies of selected articles was conducted to locate articles missed by the primary database search. Data from these reports were collected on pre-defined forms and the results were analysed.
A total of 15 cases have been reported in the literature so far and all cases are from India. Thirteen of these have been reported in the wrist region. Median duration of presentation is 7.6 months after the application of elastic band. Characteristic clinical signs are a circumferential linear scar with discharging sinus (multiple sinuses noted in around one-fourth of the cases). 'Soft tissue constriction sign' on plain radiograph is pathognomonic for this condition. Rate of missed/misdiagnosis is very high (46.7%) and it has been confused with tubercular osteomyelitis which is endemic in India. All cases responded to surgical debridement of circumferential fibrous tissue and foreign body removal with good functional outcomes.
A high index of suspicion must be maintained for this 'syndrome' in chronic osteomyelitis cases presenting with a linear, circumferential scar and discharging sinus in India. Soft tissue constriction sign on plain radiographs are pathognomonic.
曾经极为罕见的遗忘性橡皮筋综合征（即所谓的“dhaaga”综合征），如今已有多篇文献报道了多例相关病例。
全面系统地回顾文献中所有报道慢性橡皮筋综合征的文章，并举例介绍另外1例类似病例。
系统综述与病例报告。
在PubMed、EMBASE和谷歌学术数据库中检索相关文章，使用不同关键词组合进行检索，截至2017年6月20日。纳入所有报道慢性橡皮筋综合征伴引流窦道病例的文章。对所选文章的参考文献进行筛选，以查找在初始数据库检索中遗漏的文章。将这些报告中的数据收集到预定义表格中并进行分析。
迄今为止，文献中共报道了15例病例，均来自印度。其中13例发生在腕部区域。出现症状的中位时间为应用橡皮筋后7.6个月。特征性临床体征为伴有引流窦道的环形线性瘢痕（约四分之一的病例可见多个窦道）。X线平片上的“软组织收缩征”对本病具有诊断意义。漏诊/误诊率非常高（46.7%），且常与印度流行的结核性骨髓炎相混淆。所有病例经手术切除环形纤维组织和清除异物后均有良好功能转归。
在印度，对于出现线性、环形瘢痕和引流窦道的慢性骨髓炎病例，必须高度怀疑这种“综合征”。X线平片上的软组织收缩征具有诊断意义。
