• Keith A Allen, Marco Rizzo, and Annie T Sadosty.
• Department of Emergency Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin, USA.
• J Emerg Med. 2012 Jul 1;43(1):93-6.

BackgroundThe removal of metal rings from fingers is a well-described process that often employs a toothed cutting wheel or bolt cutters to sever the ring and allow it to be pried open. However, tungsten carbide (TC) rings are impervious to these traditional ring-cutting devices.Study ObjectivesWe sought to describe a method for removal of TC rings from cadaveric fingers and characterize potential complications of the technique.MethodsOn cadaveric fingers, we placed TC rings and created a snug fit by injecting a fluorescein and saline solution. The rings were removed by a controlled crushing technique using a pair of locking pliers. Fingers were inspected under magnification and using an LED (light-emitting diode) black light, and X-ray studies of each finger were obtained. Injuries were characterized.ResultsSix rings were applied and successfully removed from six cadaveric fingers through controlled ring shatter. After ring removal, two fingers demonstrated superficial (<1 mm deep) lacerations, one of which had residual debris within the wound. No phalangeal fractures were identified.ConclusionRemoval of a TC ring can be performed through controlled crushing using locking pliers. Superficial lacerations and retained debris are potential complications.Copyright © 2012 Elsevier Inc. All rights reserved.

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