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: