title: Dangers of neglect: partially embedded ring upon a finger.
abstract: Digital swelling is a common presentation in clinical practice. Patients presenting with swollen fingers to the emergency department will often have rings on their finger, which can be removed using a variety of simple non-operative techniques or by cutting the ring off and thus avoiding any long-term consequences. Very rarely, when there is a delay in presentation of these patients, serious consequences may proceed, including finger ischaemia, infection, tendon attrition or ultimately the need for surgical amputation. We present an unusual case of patient with psychiatric illness who presented late with a ring that had embedded upon the volar aspect of the index finger. The difficulties faced by the emergency care practitioners in such circumstances, the consequences of rings acting as a tourniquet and strategies for removal of rings on swollen fingers are highlighted.
authors.affiliation: Department of Trauma and Orthopaedics, Eastbourne District General Hospital, Eastbourne, UK. anandkumar@doctors.net.uk
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar
authors.forename: Huw
authors.initials: H
authors.lastname: Edwards
authors.forename: Surjit
authors.initials: S
authors.lastname: Lidder
authors.forename: Prabhakar
authors.initials: P
authors.lastname: Mestha
mesh_terms: D004487:Edema / Q000209:etiology; D005383:Finger Injuries / Q000209:etiology* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D005385:Fingers / Q000473:pathology* / Q000601:surgery; D005547:Foreign Bodies / Q000601:surgery; D006801:Humans; D007239:Infections / Q000209:etiology; D007511:Ischemia / Q000209:etiology; D055498:Jewelry / Q000009:adverse effects*; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D013710:Tendons; D014111:Tourniquets