Ring Avulsion Injuries - Finger Injury from Wedding Band

ring finger injury
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Rings are worn to be reminders, often to symbolize a significant occasion.  While wedding bands, engagement rings, or any other ring is meant to become a part of you, it's not meant to take off your finger.  Be forewarned: it can.  Injuries to fingers from rings, called ring avulsion injuries, can be serious, even leading to the loss of the finger.

  Often the injuries that result from ring avulsions don't look bad a first, but even with aggressive surgical management, they may lead to amputation. It is important that any time in injury occurs to one of your fingers while wearing a ring, but appropriate evaluation and medical attention is obtained in a timely manner.

Ring Avulsion Injuries

A ring avulsion injury occurs when a ring worn on the finger is forcefully pulled away from the finger causing damage to the soft tissues of the finger.  Often times, the injury looks minor, perhaps little or no skin injury, but the extent of the injury may be much more severe.  Most notably, the small blood vessels of the finger can become damaged causing the finger to lose its blood supply.

These injuries typically occur as a result of individuals working with machinery that catches on the ring, or from someone falling and reaching to grasp an object only to catch the ring.

  For example, comedian Jimmy Fallon recently reported an injury where he tripped on a rug and caught his ring, ultimately requiring a many-hours-long surgery and rehabilitation.

Ring avulsion injuries are classified as follows:

  • Class I: adequate circulation
  • Class II: inadequate circulation
  • Class III: complete amputation

    As mentioned, the primary concern is the blood flow to and from the digit.  In addition to direct vascular injury, arterial thrombosis may develop in the hours or days following injury.  The blood vessels may be damaged while the bone and tendons may not have been harmed, and the skin may be intact.  Therefore, even if the finger bends and is not bleeding, injuries from a ring avulsion must be carefully examined and monitored.

    Treatment

    Treatment of a suspected ring avulsion injury should include assessment by a medical professional who can thoroughly evaluate for the possibility of vascular injury.  In addition, the skin, nerves, tendons, ligaments, and bones should be evaluated to determine if treatment is necessary.  When treatment is needed, microvascular repair is the usual treatment.  This is typically performed by a hand surgery or plastic surgery specialist.  Class III injuries may be considered for replantation (reattachment) of the finger, but this surgery is not always possible depending on the degree of soft-tissue damage.

    It is important to note, that even with proper treatment, Class II injuries are susceptible to ischemia of the finger (insufficient blood flow), that may require amputation.

      Even when injury severity is recognized early, and proper treatment is initiated, the reconstructed blood vessels may not work normally. 

    Because of the severity of these injuries, many workplace environments require employees to remove rings prior to working.  This is especially important for individuals working with machinery or tools that could catch or grab on to a ringed finger.  People who enjoy home improvement tasks or sports activities should also use caution and remove rings prior to these activities.  Certainly, professional athletes remove this type of jewelry before playing physical or contact sports.

      The risk of injury may sound unlikely, but simply removing the ring from the finger may prevent a catastrophic complication.

    A Word From Verywell

    Be it a wedding band, and engagement ring, a class ring, or any other jewelry worn on the finger, there can be a serious problem as a result of injury while wearing a ring on the finger. The safest thing to do is to try and remove jewelry before performing any activities such as contact sports or heavy lifting. Taking simple steps can prevent the potential for catastrophic injury. When an injury does occur to the finger while wearing a ring, be sure the finger is evaluated in that the nerves, blood vessels, and other soft tissues are all functioning normally. Remove the ring as quickly as possible to prevent any further damage to the soft tissues. If there is any question of the severity, seek immediate medical attention as delayed treatment can lead to more catastrophic outcomes.

    Sources:

    Crosby N, et al. "Ring injuries of the finger: long-term follow-up" Hand 2014 Sep;9(3):274-81.