Rubber band syndrome, a diagnostic dilemma: case series

Abstract

Elastic bands or threads are worn on the wrist, ankle, fingers and sometimes neck, in many religious societies of India as part of their rituals or decorative purpose. It tends to stay hidden in the skin crease. When worn for a long duration, there is gradual, painless penetration of the band through the soft tissue. In neglected cases, re-epithelisation of skin over the buried band occurs. There is subsequent soft tissue infection and features suggestive of compression of the underlying connective tissue. In this article, we present a series of three cases with Rubber Band Syndrome, difficult to diagnose due to forgotten history. They were confirmed to have been suffering from Rubber Band Syndrome only after intra-operative finding of an embedded elastic band in soft tissue during surgical exploration. The buried rubber band was removed and circumferential fibrous tissue were excised followed by physiotherapy and rehabilitation. Aim was to emphasize on need of maintaining a high index of suspicion to diagnose Rubber Band Syndrome in cases, especially in young children, older individuals and people with cognitive impairment, presenting with linear, circumferential scar having compression symptoms. Surgical removal of buried rubber band was successful in all cases. Post-operative follow-up over a mean period of one year have shown a surprisingly good outcome with respect to limb function. A high index of suspicion is required to diagnose Rubber Band Syndrome in cases, especially in young children, older individuals and people with cognitive impairment, presenting with linear, circumferential scar having compression symptoms. It can be treated permanently by a simple surgery of foreign body removal and excision of circumferential fibrous tissue followed by physiotherapy and rehabilitation.