Management of a patient with a ring avulsion injury

Abstract

The purpose of this report is to describe the management of a patient with a Class I ring avulsion injury. There were no bony or skeletal injuries and both neurovascular bundles were intact, but soft tissue swelling and decreased range of motion contributed to complex management problems. Predictable patterns of range of motion limitations, secondary to adhesion formation, were addressed early in the rehabilitation program with tendon gliding exercises. Proximal interphalangeal extension splinting was initiated to combat a flexion contracture which is common when digital edema is present. Edema control techniques and scar management were also part of the hand therapy regimen. Careful assessment at each session and tissue response to exercise dictated changes in the hand therapy program. Emphasis on patient education and a comprehensive home program facilitated an early return to work.