The Use Of A Ring Block To Aid In Difficult Stuck Ring Removal Case
As a healthcare professional, you want to provide the highest standard of care possible. When a patient arrives with a stuck ring that has significant sentimental meaning, of course you want to remove it intact and without ring or finger damage if possible. In some cases, this is easier said than done. Here’s an example where a “Ring Block” (also called Digital Block or Metacarpal Block) is used to help you and your patient.
Finger before removal attempts
Finger after removal attempts
Case:
A patient arrived at a local hospital with a stuck ring due to swelling caused by an injury to the finger. The injury occurred when her dog was spooked by wildlife on a walk causing the leash to jolt and catch her finger, with resulting finger injury and progressive swelling. The stuck ring is a custom ring, made up of several rings from three generations of family with nine diamonds placed throughout the wide, intricately designed band, with engraving on the inside surface.
Upon arrival at the hospital, a nurse attempted to remove the ring by tightly wrapping the green elastic band taken from a hospital oxygen mask, around the finger. This is a fairly common hospital choice of material for the string wrap technique. The patient was experiencing significant discomfort, so they used a Ring Block to help alleviate the pain. Once “frozen”, they made multiple attempts wrapping the ringer with an oxygen mask band and taking turns trying to wiggle the ring off the finger. Although the patient tolerated this much better after the Ring Block, these attempts caused the finger to become bruised and more swollen. With no success, they decided to resort to ring cutting, which had its own challenges.
The nurse, using a high-powered rotary tool (i.e. Dremel), made two attempts to cut the ring but after several minutes of cutting there was minimal progress made. Realizing they didn’t have the tools to be successful, the physician on duty then called another local hospital where he knew they had the Ring Rescue Compression Device. The patient was transferred to the second hospital in hopes the Compression Device would allow the ring to be removed non-destructively.
Upon arrival at the second hospital, the patient was assessed and an X-ray was done to assess the patient’s finger injury. There was a minor avulsion fracture, but no unstable injury, and Dr. Spencer determined it was safe to attempt ring removal. The Ring Rescue Compression Device was applied for 2 rounds of compression to shrink finger size. Even though the “freezing” from earlier had long since worn off, this finger compression was not uncomfortable. This is due to the uniform compression forces that are within the safe zone for skin tissues (string wraps often have very high point-load forces which is why they are painful and often cause bruising and increased swelling).
Finger X-Ray before ring removal
Finger X-Ray after ring removal
After finger size was reduced, Dr. Spencer determined that ring removal would be possible, but that the manipulation techniques to walk the ring off the finger would be uncomfortable on this injured finger. Dr Spencer performed a second Ring Block with Lidocaine to help with patient discomfort, prior to ring removal. Dr. Spencer then used proper manipulation techniques and lubrication, and was able to slowly manipulate the ring off of the finger, resulting in the ring being removed intact. A second X-ray was performed after ring removal, and you can see above that there was no adverse change in the fracture, and the finger did not sustain any bruising or additional swelling and injury.
The Ring Block allowed the procedure to be performed without patient discomfort, which almost certainly would not have been possible otherwise in this case, given the nature of the finger injury, which had also been further aggravated by several failed string wrap attempts.
This case is a great example of the Ring Rescue Compression Device successfully aiding in non-destructive stuck ring removal, in the case of an injured finger, when traditional methods such as string wraps and ring cutting had failed.
Finger after non-destructive removal
As a first-line approach in ring removal, string wraps should be discouraged as they can increase tissue damage and make the problem worse if they are unsuccessful. Going straight to ring cutting if non-destructive ring removal is deemed possible, is also discouraged, particularly if the patient has sentimental attachment and financial value associated with the ring. “Do no harm” whenever possible.
When assessing the problem, determine the severity of any injury, consider patient preference, viability of non-destructive ring removal, and also viability of ring cutting based on the tools you have (cobalt, titanium, tungsten, and thicker cast rings can be extremely difficult to cut). Pick the best strategy based on all these factors, and add supplemental techniques (such as the Ring Block) when appropriate to help you achieve the best outcome.
For a further in-depth review of this case, please see the video below.
About Ring Rescue Inc.
Ring Rescue is a medical device manufacturer that provides innovative, safe and purpose-built solutions for stuck ring management. Their first of its kind, patented Compression Device, reduces finger swelling to aid in the removal of stuck rings non-destructively. Ring Rescue solutions are used by healthcare, fire/EMS, jewelry and funeral services professionals to provide an effective solution for a common problem. To date their products have aided in saving thousands of sentimental and valuable rings worldwide, furthering the company’s position as the authority in stuck ring removal.
