Ring Avulsion Injuries: A Systematic Review

Abstract

Ring avulsion injuries are commonly classified with the Urbaniak class system. Outcomes are superior for class I and II injuries, and there are select class III injuries that can be treated with replantation. Shared decision making with patients is imperative to determine whether replantation is appropriate.

Outcomes Following Replantation/Revascularization in the Hand

“…2 In the literature, the reported values of TAM depends on the level of injury and the digit injured (Table 5 and table 6). 5,17,18,[23][24][25][26][27][28] The mean TAM appears to decrease as the injuries are more proximal (Figure 4).…”

“…26 The actual distances reported by other studies is presented in Table 7 and table 8. 6,17,18,[23][24][25][26]28,[33][34][35] There were 2 studies that reported sensibility testing using SWF. Paavilainen et al found 55% of transmetacarpal replantation cases to fall within the normal range (2.83 -3.61), with diminished protective sensation (4.31) in 22%, loss of protective sensation (4.56) in 14% and loss of sensation in 9%.…”

The ‘Shoelace Sign’: just another simple thumb laceration?

“…Avulsion type injuries to the digits may occur following a fall or jump from height, and include ring avulsion injuries which are well described 1. Nerve avulsion injuries are uncommon and may easily be overlooked.…”

When Marriage Hurts: A Literature Review of Embedded Jewellery Ring Injuries

“…Rarely, they can result in complex traumatic avulsion injuries to the hand when the ring is caught on an object and forcefully pulled. These injuries can necessitate a range of treatments, from simple wound closure through to microvascular repair and amputation [ 4 ]. Rarer still, a ring can become embedded into the soft tissue of a digit to the extent that it is not at all visible to the eye.…”