What's the Diagnosis by Dr. Kim Chavez

Answer:  Circumferential de-gloving injury of ring finger with signs of vascular compromise and immediate surgical exploration in the OR is required to attempt finger salvage

Finger De-Gloving Injuries

  • Wedding bands are a common cause of de-gloving injuries
  • Maintain a high suspicion for vascular compromise particularly in circumferential injuries
  • Always evaluate for signs of vascular injury by checking for
    • Appearance (normal vs. dusky)
    • Capillary refill
    • Sensorary exam
    • Pulse oximetry waveform
    • Digital arterial Doppler signals
  • Isolate each joint and do a full exam to find subtle tendon injuries

Patient course

  • Revascularized by plastic surgery in the OR
  • Leeches were applied to the distal finger intermittently for a week in lieu of inadequate venous drainage (leeches!)

At Plastic Surgery Followup: