Ring avulsion is a traumatic injury that occurs when a ring is caught on an object and is yanked off your finger suddenly and rapidly, potentially causing severe tissue damage. It requires emergency care.
The force and pressure of pulling the ring can strip it off and damage finger skin and tissues, including muscles, tendons, and bones. This is called “degloving” and refers to a complete separation of the skin from the underlying tissue.
Ring avulsion is a medical emergency and can cause permanent disability or finger loss if not treated promptly.
Ring avulsion isn’t common, but it is possible. Jimmy Fallon, host of “The Tonight Show,” brought this type of injury to national attention in 2015 when his wedding ring got caught on the edge of a table when he fell. He reported that surgeons worked on his finger for over six hours, and even though his finger wasn’t amputated, he wore a cast on his ring finger for weeks.
Read on to learn more about how ring avulsion can happen, how it’s treated, and how you can prevent it from happening to you.
Ring avulsion occurs when a ring on a finger gets caught on an object and is pulled off the finger quickly and forcefully. This often happens when a person wearing a ring gets it caught on metal equipment, such as a:
- garbage truck
- steel fence
- basketball hoop
Machines can pull a ring off your finger at extremely high speeds. Rings can also get yanked off your fingers when they get caught on metal and your body weight pulls you to the ground.
When an avulsion occurs, the pressure the ring places on the tissue can bruise or damage blood vessels, causing a contusion injury, which isn’t too serious.
In severe cases of avulsion, the ring can tear or strip off skin, blood vessels, and tendons along the entire length of your finger. Sometimes, this process may expose your finger bones underneath.
Avulsion injuries can also result in finger fractures.
Seek immediate emergency medical attention if you experience an avulsion injury.
If your finger is still intact, you should stop any bleeding by applying pressure and wrapping the finger with bandages. You should also keep your hand elevated to reduce any swelling.
If your finger has significant bleeding or has been amputated because of the injury, you should call an ambulance or have someone take you to the emergency room.
Before you leave for the ER, someone should wash the unattached finger with clean water. Then, wrap the finger in moist gauze and put it in a tightly sealed bag. You should keep the bag on ice until you reach medical care. Don’t put the amputated finger itself directly on ice.
Finger avulsion requires quick emergency careIf you experience finger avulsion, do not delay getting medical attention, even if the injury seems minor.
Getting into surgery quicker can improve your outlook and may restore use of your finger.
Anyone wearing a ring is at risk of ring avulsion injury, especially if they wear it while operating industrial machinery where a ring could become stuck and yanked off.
Even if you aren’t working with machinery, it’s still possible to get a ring avulsion injury. For instance, large, heavy objects, such as fences, thick ropes, or nets, can also catch your ring while you’re moving or falling at high speed. A ring can also get caught on heavy objects, such as kitchen appliances or furniture, which can easily pull it off with a sharp edge or corner.
Loose or large rings are more likely to get caught on a piece of metal or equipment because of the open space between the ring and your finger. To reduce your risk, ensure that any rings you wear are properly fitted to your finger.
The treatment options depend on the severity of your injury. Your surgeon will assess your injury according to the Urbaniak classification:
- Class I: Blood is still circulating through the finger, so you may just need your finger tissues and bones repaired.
- Class II: Blood isn’t circulating through your finger, so your surgeon may need to reconnect the blood vessels before they can repair any tissue or bone.
- Class III: Your finger has been completely stripped of tissue down to the bone or cut off. Your surgeon may be able to reattach the finger or the vessels, but you may not be able to use your finger as well as before the injury.
If your finger bones were broken, you may need to wear a cast for several weeks or longer until the bones heal. If your finger was cut open during the injury, you may need stitches to sew up the cut, and the injury should heal within several weeks.
Doctors typically treat ring avulsions with microsurgery, which involves using specialized instruments and microscopes to repair small blood vessels and nerves.
Microsurgery techniques may be used to treat any nerve, blood vessel, or tendon damage. Advances in this type of surgery have improved outcomes for severe cases.
If you have a class III injury, your surgeon may be able to reattach, or “replant,” the finger using microsurgery to repair any nerves, blood vessels, or bone fractures. This surgery can take several hours and require weeks to months of recovery before the finger can be used again.
The outlook for ring avulsion depends on the severity of the injury. After treatment, Class I injuries generally heal faster after treatment than Class III injuries. Because repair depends on the specific tissues and bones that were damaged and the extent of that damage, recovery time can vary widely.
Recovery may generally take several months for the bones to reset and for any cuts to heal. Depending on the injury, you may be able to resume typical activities with your finger in a few months, though repair after a complete amputation can take longer to heal.
After treatment, you may wear a brace, splint, or cast for weeks.
You may also need occupational therapy to help you regain full movement of your finger. This type of therapy helps you learn to perform daily tasks more easily.
If your nerves were damaged, you may not be able to feel or sense pressures or temperatures as well as before the injury. If bones or tendons were injured, you may not be able to move your finger to the full range of motion.
This injury isn’t possible if you don’t wear rings. Other options include wearing your ring on a necklace or getting a tattoo in the shape of a ring on your finger.
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But if you wear metal rings, it’s best to avoid wearing them in situations where they can get caught on something, such as heavy machinery. You should also take your rings off before you play sports or use any exercise equipment.
Wearing rings that fit appropriately, rather than rings that are too large, creates less space between the finger and ring where it can catch on something.
Keep your ring in a safe place when it’s not on your finger. If you’re worried about it getting stolen or lost, leave it at home or in a locker.
Ring avulsion happens when a ring is removed from a finger quickly and with force. It usually results in removing skin and other tissue from the finger, but it can also result in amputation.
Quick surgical treatment may restore the use of the finger. However, depending on the severity of the injury, you can experience changes in sensation and range of motion.
The surgery for ring avulsion can take more than a few hours, but the time varies widely depending on the extent of the damage.
To prevent ring avulsion injuries, consider removing rings before operating heavy machinery or playing sports.