A Case of an Elderly Patient With Rubber Band Syndrome

Abstract

Rubber band syndrome is a relatively rare disease in which a rubber band around a limb becomes embedded under the skin, resulting in tissue damage. Most reported cases are in children, and its occurrence in adults is considered extremely rare. We present a case of a 71-year-old patient with cognitive impairment, in whom a rubber band around the wrist became embedded under the skin. The examination of the distinctive circumferential scar, ultrasonography, x-ray, and magnetic resonance imaging led to the diagnosis of rubber band syndrome. To avoid further damage to the tissue, surgical removal of the band was conducted. When elderly patients with cognitive impairment present with chief complaints of swelling and contracture in the limbs due to an unknown cause, accompanied by a circumferential scar on the affected limb, rubber band syndrome should be considered. Due to risk of deep tissue necrosis, prompt band removal is necessary.

Rubber band syndrome, a diagnostic dilemma: case series

“…Young children, older individuals and people with cognitive disability do not understand the risk of having a rubber band in place, they have difficulty communicating, or they are unclear on the process of injury that could occur because of problems with memory. 16 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 may easily be misdiagnosed as a case of hypertrophic scar and managed accordingly with reconstructive procedures, but to no favourable outcome.…”

Rubber Band Syndrome: A Rare Orthopaedic Condition in South Africa

“…Due to their rapid growth rate and increasing circumference of the wrist, the bands easily erode through the skin. (1)(2)(3)(4)(5) This gradual process is often painless and may not cause noticeable signs or symptoms as it occurs in a pre-existing skin crease which heals over the band. The slow penetration and constriction, coupled with rapid healing of divided structures, continues deeply through structures of the wrist.…”

“…(1) Commonly practiced in regions of India, cases are described in which a forgotten thread or elastic band has slipped into a skin crease on the wrist or ankle. (2)(3)(4) This becomes embedded in the skin and is no longer visible to the child's carers with disastrous consequences. (4) Over time the thread or elastic band becomes embedded within the skin through the dual process of constriction around a rapidly growing limb combined with swift healing, forming a well epithelialised scar around the site of constriction, most commonly around the wrist or ankle.…”

“…(4) Over time the thread or elastic band becomes embedded within the skin through the dual process of constriction around a rapidly growing limb combined with swift healing, forming a well epithelialised scar around the site of constriction, most commonly around the wrist or ankle. (2,4) The band burrows circumferentially towards the bone and easily disrupts neurovascular structures and tendons in its path, resulting in distal oedema and loss of hand function. (2)(3)(4) The presence of the foreign body results in a chronic inflammatory process leading to a non-healing wound or draining sinus.…”

“…(2,4) The band burrows circumferentially towards the bone and easily disrupts neurovascular structures and tendons in its path, resulting in distal oedema and loss of hand function. (2)(3)(4) The presence of the foreign body results in a chronic inflammatory process leading to a non-healing wound or draining sinus. In the wrist, the sinus is usually located on the volar aspect of the wrist on the radial side.…”