Ring avulsion injury: Difference between revisions
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*History of working with machinery or getting digit caught in door | *History of working with machinery or getting digit caught in door | ||
*Pain, bleeding, lack of sensation | *Pain, bleeding, lack of sensation | ||
===Classes of Injury<ref>Jones M, Gujral S. Ring Avulsion Injuries. Eplasty. 2016;16:ic5.</ref>=== | |||
''Based on circulatory status'' | |||
*Class I: Circulation adequate | |||
*Class II: Circulation inadequate | |||
*Class III: Complete degloving or complete amputation | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Hand and finger injury DDX}} | {{Hand and finger injury DDX}} | ||
{{ | {{Extremity trauma DDX}} | ||
==Evaluation== | ==Evaluation== | ||
*Assess for distal neurovascular function | *[[Hand exam]] | ||
* | **Assess for distal neurovascular function | ||
*Dedicated digit x-ray | |||
==Management== | ==Management== | ||
*Will require consultation with hand surgeon for operative repair | *Will require consultation with hand surgeon for operative repair | ||
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==External Links== | ==External Links== | ||
*https://www.orthobullets.com/hand/6061/ring-avulsion-injuries | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Trauma]] | |||
Latest revision as of 06:13, 6 April 2018
Background
- Sudden pull on a ring results in severe soft tissue avulsion injury
- Can range from circumferential soft tissue laceration to complete amputation
- Often with concomitant neurovascular damage
Clinical Features
- Typically only one digit involved
- History of working with machinery or getting digit caught in door
- Pain, bleeding, lack of sensation
Classes of Injury[1]
Based on circulatory status
- Class I: Circulation adequate
- Class II: Circulation inadequate
- Class III: Complete degloving or complete amputation
Differential Diagnosis
Hand and finger injuries
- Distal finger
- Other finger/thumb
- Boutonniere deformity
- Mallet finger
- Jammed finger
- Jersey finger
- Trigger finger
- Ring avulsion injury
- De Quervain tenosynovitis
- Infiltrative tenosynovitis
- Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
- Hand
- Wrist
- Drummer's wrist
- Ganglion cyst
- Lunotriquetral ligament instability
- Scaphoid fracture
- Extensor digitorum tenosynovitis
- Compressive neuropathy ("bracelet syndrome")
- Intersection syndrome
- Snapping Extensor Carpi Ulnaris
- Vaughn Jackson syndrome
- General
Extremity trauma
- Compartment syndrome
- Contusion
- Crush syndrome
- Degloving injury
- Fracture
- Laceration
- Myositis ossificans
- Open joint injury
- Peripheral nerve injury
- Rhabdomyolysis
- Tendon injury
- Vascular injury
Evaluation
- Hand exam
- Assess for distal neurovascular function
- Dedicated digit x-ray
Management
- Will require consultation with hand surgeon for operative repair
- Antibiotics
- Cefazolin 1 g IV
- Tetanus prophylaxis
Disposition
- Admit
See Also
External Links
References
- ↑ Jones M, Gujral S. Ring Avulsion Injuries. Eplasty. 2016;16:ic5.