Chronic Ring Tourniquet Syndrome: A Rare Case Report with A Viable Digit

Abstract

Ring Tourniquet Syndrome (RTS) is an acute condition in which a circumferential object (jewellery or a metal nut) is impacted over the base of a digit causing a constriction effect over the neurovascular pedicles. If left untreated, the resultant edema and constriction will lead on to ischemia and necrosis of the affected digit, resulting in amputation. Removing the ring requires utmost gentleness in order to avoid injury to the surrounding tissues and applying force just over the metal ring to either slide it through by threading technique or by cutting it. We report a rare case of 40-year-old female presented with pain and swelling in the right index finger due to metal ring impaction after trivial trauma for over a week. Poor pain tolerance and poor compliance required intravenous sedation for removal. Intraoperatively, the ring was loosely lodged just above the extensor apparatus, allowing partial mobility preserving the vascular pedicles. It was successfully removed using a bone cutter. The patient was discharged the next day with antibiotics, and follow-up showed complete healing and functional recovery.