Triangular pyramidal configuration of three treads for ring removal

Abstract

A 40-year-old woman arrived at our emergency department with her wedding ring firmly stuck on her 4th digit after wearing it for a decade. Despite her attempts to remove it, the swollen finger tightly incarcerated the ring. First, we tried to get rid of the ring by simply pulling it off with lubricants. Several attempts were made to remove the ring without success. Subsequently, an elastic tape was tightly wrapped around the finger from its top to the ring, before we try to unwound proximal to the ring and pull it off. But the patient, allergic to lidocaine, felt itchy, and finally we abandoned these methods.

She rejected to cut the ring off. Consequently, three 1–0 silk threads, arranged like a triangular pyramid (Figure 1A), were threaded through the ring using a mosquito forceps. As one medical staff kept pulling two threads (the black arrows), another simultaneously pulled the remaining thread with one hand (the white arrow) while gently manipulating the ring and rubbing the finger from distal to proximal with the other hand. Eventually, the ring slowly slipped off, marking the first reported use of this three-string method for ring removal.

Conventional methods to remove a ring mainly consist of simple pulling with lubricants, binding a string or an elastic tape in the distal part of the finger,^{1, 2} exsanguinating a finger with a distal intravenous tourniquet,³ and cutting a ring. The challenge lies in applying sufficient peripheral force without causing harm. The power to pull peripherally is important; however, clinicians cannot often give the proper power to a ring. The three-thread method stands out for its simplicity and effectiveness, likely becoming a common choice among clinicians. This method, especially when combined with finger-binding, offers a viable option for challenging cases. Based on this approach, we developed a device (Figure 1B) featuring a 3 mm wooden board with three attached nuts and screws. The threads are secured within the screws, and the device includes magnets to enhance pulling power with a metal wall. This innovation enables a single clinician to effortlessly remove a ring. The device holds promise as one of the evolving options for ring removal, offering a sleek and effective solution for challenging cases in the future.

None.

Approval of the research protocol: N/A.

Informed Consent: N/A.

Registry and the Registration No. of the study/Trial: N/A.

Animal Studies: N/A.