What is ring avulsion?

Ring avulsion happens when a ring on one of your fingers is caught on an object and gets yanked off suddenly and rapidly. The force and pressure of the ring being pulled can strip off and damage finger tissues, including muscles, tendons, and bones. This is called “degloving.”

Ring avulsion isn’t common, but it is possible. Jimmy Fallon, host of “The Tonight Show,” brought this type of injury to national attention in 2015 when his wedding ring got caught on the edge of a table when he fell. He reported that surgeons worked on his finger for over six hours, and even though his finger wasn’t amputated, he wore a cast on his ring finger for weeks.

Read on to learn more about how ring avulsion can happen, how it’s treated, and how you can prevent it from happening to you.

How does ring avulsion happen?

Ring avulsion is caused when a ring on your finger gets caught on an object and is pulled off your finger quickly and forcefully. This often happens when a person wearing a ring gets it caught on metal equipment, such as a garbage truck, a steel fence, or a basketball hoop.

Machines can pull a ring off your finger at extremely high speeds. Rings can also get yanked off your fingers when they get caught on metal and your body weight pulls you to the ground.

When avulsion happens, the pressure that the ring places on the tissue can bruise or damage blood vessels. This causes a contusion injury, which isn’t too serious.

In severe cases of avulsion, the ring can tear or strip off skin, blood vessels, and tendons along the entire length of your finger. Sometimes, this process may expose your finger bones underneath.

Who’s at risk for this condition?

Anyone wearing a ring is at risk for a ring avulsion injury, especially if you wear a ring while operating industrial machinery.

Large, heavy objects, such as fences, thick ropes, or nets, can also catch your ring while you’re moving or falling at a high speed.

Your ring can also get caught on heavy objects, such as kitchen appliances or furniture, that can easily pull your ring off with a sharp edge or corner.

Loose or large rings are more likely to get caught on a piece of metal or equipment because of the open space between the ring and your finger. To reduce your risk, ensure that any rings you wear are properly fitted to your finger.

What to do if it happens to you

If you experience an avulsion injury, seek immediate medical attention.

If your finger is still intact, you should stop any bleeding by applying pressure and using bandages to wrap the finger. You should also keep your hand elevated to reduce any swelling.

If your finger has significant bleeding or has been amputated because of the injury, you should call an ambulance or have someone take you to the emergency room.

Before you leave for the ER, you should wash the unattached finger with clean water. Then, wrap the finger in moist gauze and put it in a tightly sealed bag. You should keep the bag iced until you reach medical care. Don’t put the amputated finger itself on ice.

What treatment options are available?

Your treatment options will depend on the severity of your injury. Your surgeon will assess your injury according to the Urbaniak classification:

  • Class I: Blood is still circulating through the finger, so you may just need your finger tissues and bones repaired.
  • Class II: Blood isn’t circulating through your finger, so your surgeon may need to reconnect the blood vessels before they can repair any tissue or bone.
  • Class III: Your finger has been completely stripped of tissue down to the bone or cut off. Your surgeon may be able to reattach the finger or the vessels, but you may not be able to use your finger as well as before the injury.

If your finger bones were broken, you may need to wear a cast for several weeks or longer until the bones reset. If your finger was cut open during the injury, you may need stitches to sew up the cut, and the injury should heal within several weeks.

Microsurgery techniques may be used treat any nerve, blood vessel, and tendon damage. If you have a class III injury, your surgeon may be able to reattach, or “replant,” the finger using microsurgery to repair any nerves, blood vessels, or bone fractures. This surgery can take several hours and require weeks of recovery before the finger can be used again.

What’s the outlook?

Depending on how severe your injury is, recovery can take up to several months before the bones reset and any cuts heal. Depending on the injury, you should be able to resume normal activities with your finger in 5 to 10 weeks.

If your nerves were damaged, you may not be able to feel or sense pressures or temperatures as well as before the injury. If bones or tendons were injured, you may not be able to move your finger to the full range of motion. Your doctor may recommend occupational therapy to help you regain full movement of your finger.

How to prevent ring avulsion

This injury isn’t possible if you don’t wear any rings.

But if you’re married or wear rings for another reason, avoid wearing them in situations where the ring can get caught on something, such as heavy machinery. You should take your rings off before you play sports or use any exercise equipment, too.

Keep your ring stored in a safe place when it’s not on your finger. If you’re worried about a ring getting stolen or lost, leave it at home or in a locker.