A baby is brought to the hospital emergency department with excruciating pain in a toe which is red and swollen. The parents and doctors are mystified by what is causing the pain.
Only when the appendage is put under a powerful microscope does it become clear that a hair has wrapped itself around the toe, and is slowly slicing through the skin. Left untreated, the toe could require amputation.
Canberra Hospital senior plastic surgery registrar Muhammad Ali Hussain has shed new light on toe tourniquet syndrome in a paper published in Modern Plastic Surgery journal, presenting it at a conference in Malaysia.
Dr Hussain said the syndrome usually involved a stray hair from a blonde-haired woman falling onto carpet and wrapping itself around the toe of a fair-skinned baby or toddler.
''I've treated about three or four of them myself, but a lot of people are not aware of it, even some doctors,'' he said.
I've treated about three or four of them myself, but a lot of people are not aware of it, even some doctors
''They get entangled and the mother doesn't notice what has happened until the time they start crying and they don't know exactly what's happening, why they're crying. By the time they present [at hospital] it's already a couple of days and it's begun cutting through the toe.
''In a fair-coloured child and with blonde-coloured hair you can't identify there is a hair. Even under a microscope it's difficult.''
Dr Hussain said the injury was rare, but happened more often in summer, when children were more likely to be barefoot.
Generally there's little that parents can do to avoid a toe tourniquet injury, but Dr Hussain and his colleague, consultant plastic surgeon Yasantha Rajapakse, said simple precautions could reduce the risks of other common childhood injuries.
Dr Rajapakse said children commonly suffer serious injuries if a door shuts on a finger, caused either by the wind blowing it or an older sibling slamming it.
''That's one of our most common presentations: little child, door slams, usually as a result of an older brother or sister,'' he said.
Dr Rajapakse said a simple door stopper could reduce the chances of a door slam injury.
''I actually tell a lot of my friends who have kids … if you've got toddlers running around, they're actually a great thing,'' he said.
Children also have a habit of getting fingers stuck inside items such as key-ring ornaments, he said. In some cases, the fire brigade have to free trapped fingers.
''You can't live in a police state at home and you can't prevent certain things, except by keeping a close eye on a child,'' Dr Rajapakse said.