How to “Wring” the Ring Safely From Your Patient’s Hand: The String Technique

December 31, 2006

When treating a patient with an injuredhand, remove all rings as soonas possible.

When treating a patient with an injuredhand, remove all rings as soonas possible. As inflammation develops,edema may complicate ring removal.A tight-fitting ring can causearterial compression and ischemia ifnot removed in time.Soap or lubricant jelly can facilitateyour efforts to remove a ring.If unsuccessful, try the string technique(Figure).Begin by wrapping 2-0 or 3-0nylon suture tightly around the fingerjust distal to the ring in a distal direction.Next, slip the proximal end of thestring under the ring. Then pull theproximal end of the suture over thering and firmly retract it over the axisof the finger distally. As each coil of sutureunwinds, it pulls the ring slightlyover the coiled suture until it is free.If the string technique fails, removethe ring with a mechanicalring cutter. Take care to avoid injuringthe patient's hand in the process.-- Mark A. Brandenburg, MD
   Tulsa, Okla
-- Linda Hawkins, MD
-- Gary Quick, MD
   University of Oklahoma