A Modified String Technique for Atraumatic Ring Removal

Background: We describe a modified string technique for ring removal from an edematous finger, a critical step in the initial treatment of a patient with upper-extremity trauma. Technique: This technique involves multiple sutures looped around the ring to provide differential tension on the ring as it is advanced distally over a lubricated digit. With the use of an assistant, the ring can be advanced in caterpillar fashion without sliding back proximal when the direct pressure is released as a result of edema. Conclusions: This multisuture technique adds to the armamentarium of methods for ring removal in the setting of upper-extremity trauma without reverting to alternate techniques for cutting or shattering the ring.