An unusual ring injury

Drake, Douglas A.; Lewis, Frank; Newmeyer, William L.; Kilgore, Eugene S.

doi:10.1016/s0363-5023(77)80093-2

Cited by 16 publications

(3 citation statements)

References 1 publication

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“…A MEDLINE search of English-language journals revealed only thirteen cases since 1977. [1][2][3][4][5][6][7][8][9][10][11][12] The paucity of reported cases may be due to under-reporting rather than being a clinical rarity.…”

Section: Discussionmentioning

confidence: 99%

The embedded ring injury

2005

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Section: Discussionmentioning

confidence: 99%

The embedded ring injury

2005

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“…[1][2][3][4][5][6][7][8][9] In nine cases, a history of mental illness was reported, and in one, the patient was noted to have had several strokes, which altered the patient's cognitive function. All patients were adults except one.…”

Section: Discussionmentioning

confidence: 99%

The Embedded Ring Injury — Case Report and Review of Literature

Deshmukh

Stothard

2003

Hand Surg.

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“…Chronic embedded ring injury, which has a very dramatic appearance, is very rare, with only approximately 20 cases previously reported in the English literature. [1][2][3][4][5][6][7][8][9][10] In most of the reported cases, the ring was simply removed with a ring cutter in the emergency setting, and few surgical interventions were required. There have been only a few reports of sensory disturbance of the finger with an embedded ring.…”

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confidence: 99%

Entrapment of Digital Nerves due to an Embedded Ring: A Case Report

Uemura

Takamatsu

Okada

et al. 2014

J reconstr Microsurg

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Chronic embedded ring injury, which has a very dramatic appearance, is very rare, with only approximately 20 cases previously reported in the English literature. [1][2][3][4][5][6][7][8][9][10] In most of the reported cases, the ring was simply removed with a ring cutter in the emergency setting, and few surgical interventions were required. There have been only a few reports of sensory disturbance of the finger with an embedded ring. 2,4,8 However, the appearances of the digital nerves have never been confirmed with a surgical procedure when the ring was removed. This is the first case report of a chronic embedded ring injury in which severe constriction of the digital nerves by the embedded ring was demonstrated on surgical exploration, and atraumatic neurolysis of the digital nerves was required.A 73-year-old woman presented with an embedded ring in her right ring finger, with swelling and foul discharge after a blow. She had been wearing the ring for more than 20 years, and the ring had been embedded for 10 years. She had previously received psychotherapy and had taken orally antianxiety agents for few years, but she was on no drugs at the time of presentation. The patient reported that she had gained weight from 38 kg early in life to 62 kg recently. On examination, only the dorsal part of the ring could be seen above the skin dorsally, and an intact bridge of skin overlaid the volar aspect of the ring (►Fig. 1). The ring finger was swollen with foul discharge, but the distal circulation was satisfactory. The range of motion was limited to moderate flexion. On neurological examination, although there was no numbness, sensation distal to the buried ring was diminished: Semmes Weinstein monofilament values were 4.56 on the ulnar side and 4.31 on the radial side; static two-point discrimination values were 10 mm on the ulnar side and 8 mm on the radial side. Plain radiographs of the ring finger showed the completely buried ring within the volar soft tissue, but bone scalloping was not appreciable in the proximal phalanx (►Fig. 2).Surgical exploration was performed under brachial plexus anesthesia to avoid damaging the neurovascular bundles during removal of the ring. A Brunner zigzag incision was made on the volar aspect of the ring finger. The neurovascular bundles, especially the digital nerves, were extremely entrapped between the ring and the proximal phalanx (►Fig. 3), and the flexor digitorum profundus tendon was ruptured. The neurovascular bundles were released carefully, and then the ring was removed safely after opening the stems of the ring without using a ring cutter because of the divided original design of the bottom of the ring (►Fig. 4). The hypertrophic granulation tissue at the entrance wounds was debrided, and the skin was primarily closed.The wound healed uneventfully with oral antibiotic coverage. About 1 year and 7 months after the surgery, the sensory disturbance of the finger improved without numbness; Semmes Weinstein monofilament values were 3.61 on the ulnar side and 2.83 on the radial...

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An unusual ring injury

Cited by 16 publications

References 1 publication

The embedded ring injury

The embedded ring injury

The Embedded Ring Injury — Case Report and Review of Literature

Entrapment of Digital Nerves due to an Embedded Ring: A Case Report

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