Retrospective Analysis of Finger Entrapments

What a Ratchet! A Gripping Case Report of an Entrapped Finger with an Unyielding Wrench

“…When the aforementioned techniques are unsuccessful, use of dental carbide or diamond burs (1) under copious irrigation and (2) in cut and rest intervals is often attempted. [6][7][8][9] However, even these instruments may be insufficient in the destructive removal of objects composed of hard metallic alloys.…”

“…7–9 Additionally, presentation of finger entrapment with hard metallic household or workplace items (eg, lug nuts, wrenches) has become more frequent. 2,6 These materials resist traditional ring and bolt cutters. 2,4–9 Alternative destructive techniques exploit the “brittleness” of these metal alloys to shatter rather than cut them.…”

“…[7][8][9] In addition to ring entrapment, plastic and hand surgeons have increasingly encountered digit entrapment with household or workplace items, like lug nuts, washers, door latches, and wrenches. 2,6 These items are typically composed of the aforementioned alloys. In comparison with traditional metals, these alloys fall higher on the Mohs hardness scale, often resulting in ineffective removal with traditional destructive tools.…”

“…These methods include, but are not limited to, arm elevation and icepack compression, lubrication with axial traction, and specialized advancement techniques used to gently manipulate the ring from the entrapped digit. 2,3,5,6 In the event that these methods fail, destructive tools (eg, ring cutter, electric saw, dental drill, Midas rex) become necessary to cut or break the ring. 2,[4][5][6][7][8][9] Rings are traditionally made from metals like gold, silver, and platinum, although alloys like tungsten, titanium, and stainless steel have been recently popularized.…”

“…2,3,5,6 In the event that these methods fail, destructive tools (eg, ring cutter, electric saw, dental drill, Midas rex) become necessary to cut or break the ring. 2,4–9…”