Limb Tourniquet Syndrome: A Cautionary Tale

The document reports a unique case of limb tourniquet syndrome in an 80-year-old male patient with dementia, who presented with a discolored, swollen, and painful distal third of the left leg. The condition was caused by two rubber bands that the patient had used to hold up his socks and had become embedded in the tissues due to prolonged neglect. This led to skin changes, chronic arterial ischemia, lymphoedema, chronic venous hypertension, and massive periosteal reaction. The rubber bands were surgically removed, and the patient was treated with antibiotics and debridement. The case is notable for being the first reported instance of limb tourniquet syndrome with abnormal periosteal reaction and skeletal involvement. The authors emphasize the importance of high clinical suspicion for such conditions in vulnerable populations, such as the elderly with dementia or self-neglect, to prevent irreversible limb damage and amputation.