Abstract
Ring tourniquet syndrome is a strangulation injury, usually at the proximal finger or toe, caused by a rigid circular metal object. The resulting ischemia can lead to necrosis, permanent nerve and/or tissue damage, and amputation of the digit. There are numerous non-cutting methods for removing the ring; however, edema, fractures, or arthrosis of the site can occasionally make these techniques difficult or impossible. While ring cutters, manual or electric, are the first choice for resolving ring tourniquet caused by metal jewelry, these tools are not readily available everywhere. Resolution of ring tourniquet with high-speed rotary tools has been previously described as a tertiary method. Here we describe the use of a high-speed dental tool as a primary ring cutting method for the resolution of ring tourniquet in a patient with significant edema in a low-resource setting.
Highlights
Manual or electric, are the first choice for resolving ring tourniquet caused by metal jewelry, these tools are not readily available everywhere
Resolution of ring tourniquet with high-speed rotary tools has been previously described as a tertiary method
Ring tourniquet syndrome is a strangulation injury caused by a rigid circular object, most often a piece of jewelry or metal nut
Summary
Ring tourniquet syndrome is a strangulation injury caused by a rigid circular object, most often a piece of jewelry or metal nut. For hardened metals, such as stainless steel or tungsten carbide rings, diamond tipped cutting instruments or shattering the ring with a hammer may be necessary [3] In this case, a 41-year-old Maori female presented to a rural island health outpost in the Cook Islands with pain and swelling of the left ring finger, which she first noticed three days ago following a ten-hour plane flight. We present the successful resolution of a ring tourniquet using a high-speed dental drill in a rural health clinic. VIDEO 1: This video shows the use of a high-speed dental handpiece to resolve a ring tourniquet; several burrs were used to remove this gold and metal alloy wedding ring from the patient’s finger. The patient had a full recovery without any complications or loss of function upon follow-up at four weeks
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