Horn Amanda, Freniere Brian, Sheng Alexander Y
Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
Lahey Hospital and Medical Center, Department of Plastic Surgery, Burlington, Massachusetts.
Clin Pract Cases Emerg Med. 2021 Feb;5(1):75-78. doi: 10.5811/cpcem.2020.11.49917.
Ring avulsion injuries consist of a characteristic injury pattern resulting from sudden intense force pulling on a finger ring. While ring avulsion injury is a known entity in the hand surgery literature, there is scant description of the injury pattern in emergency medicine, much less its management and transfer implications in the emergency department (ED).
This is a report of a patient presenting to the ED with ring avulsion injury after a workplace accident, initially transferred to a tertiary care hospital with general hand surgery, who then required a second transfer for consideration of microsurgical revascularization.
In addition to fully assessing the degree of injury, including neurovascular and tendon involvement, emergency physicians must recognize cases of severe ring avulsion injuries without complete amputation as potential opportunities for microsurgical revascularization.
环形撕脱伤是由突然作用于指环的强大外力导致的一种特征性损伤模式。虽然环形撕脱伤在手部外科文献中是一种已知的病症,但在急诊医学领域对其损伤模式的描述却很少,更不用说在急诊科对其处理及转诊的意义了。
本文报告了一名患者,在工作场所意外事故后因环形撕脱伤就诊于急诊科,最初被转诊至一家设有普通手外科的三级医院,随后因考虑进行显微外科血管重建而需要再次转诊。
除了全面评估损伤程度,包括神经血管和肌腱受累情况外,急诊医生必须认识到,对于未完全离断的严重环形撕脱伤病例,是进行显微外科血管重建的潜在机会。