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Ligature effect on wrist of a child
  1. Ranjit Bhosale1,
  2. Shruthi Chandrasekar1,
  3. Kiran Trambak Nerkar2 and
  4. Raja Tiwari1
  1. 1Plastic and Reconstructive Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Plastic Surgery, Aakar Aesthetics, Nashik, Maharashtra, India
  1. Correspondence to Dr Raja Tiwari; tiwariraja1981{at}


A rubber band worn around a limb in an infant has the potential to cut through the tissues. The cutting potential of a rubber band is proportional to the strain within the band. A circumferential scar over the wrist with multiple discharging sinuses is the usual presentation. Such presentations should raise the suspicion of ‘the rubber band syndrome’. A forgotten band migrates through the tissues and the skin epithelialises over it. As a result, continuity and function in the limb may be maintained, leading to misdiagnosis and wrong treatment. A high level of suspicion and treatment in the form of surgical removal and adequate debridement at first followed by formal reconstruction of deficits secondarily are required in the management of such patients.

  • Preventative pediatrics
  • Plastic and reconstructive surgery
  • Paediatric Surgery

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  • Contributors RT and KTN were responsible for the ideology, treatment and data collection. RB drafted the first version of the paper. SC has been actively involved in proofreading and formatting of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.