Ring avulsion injuries

Patients may catch their wedding band or other finger ring on moving machinery or on a protrusion from a surface as they jump or move away from it. The sudden pull on the ring may result in a small wound, a circumferential wound, or an amputation. These injuries have been classified most recently (Kay) as follows:

With this mechanism, the actual extent of injury is always much greater than what it appears. High-speed photography of the injury in a cadaver model has shown that relatively little force is required to momentarily turn the entire soft tissue envelope of the finger inside out. Because the external wound may be small and motion maintained through the intact flexor and extensor tendons, the extent of injury may not be appreciated initially and the patient may be discharged, only develop signs of progressive ischemia. Arterial thrombosis along the length of the finger may prevent successful revascularization even with grafts and the possibility of a proximal or even ray amputation should be discussed with the patient at the time of initial evaluation.

Ring Avulsion Injuries
e-Hand Previous Next Search Chapter Textbook