Andrej Salibi, MD, a surgeon at Sheffield Teaching Hospital in Sheffield, U.K., told Reuters Health by email, “Titanium rings, although very hard to cut, can be removed simply by using bolt cutters, which should be available in any hospital.”
Dr. Salibi, and Andrew N. Morritt, MB, ChB, of the hospital’s plastic surgery department, described a patient who presented to the emergency department with a painful, swollen finger. ED personnel tried unsuccessfully to remove the ring using traditional methods, including arm elevation, finger lubrication, and a regular ring cutter.
They then called the fire department, whose responders tried unsuccessfully to remove the ring using specialized cutting equipment.
The plastic surgery service then attempted several hours of hand elevation and use of ring cutters. Finally, they cut the titanium ring successfully using a pair of bolt cutters that were obtained from the surgical theater. After the cut, they pried the ring open using large paper clips.
Titanium rings have become increasingly widespread because of their durability, low risk of allergies, and light weight, the authors note in a letter to the editor published August 13 in Emergency Medicine Journal.
However, ring constriction is fairly common and titanium rings remain difficult to remove in a timely manner to prevent tissue necrosis, they wrote.
“Ring finger construction is an emergency. However, it all depends on body temperature, anatomical abnormalities in the finger, and the circumstances that led to the constriction. Conservative measures include simply arm elevation initially then lubrication, and finally finger binding techniques as a last resort before embarking on cutting the ring,” Dr. Salibi said.
Common methods to remove titanium rings include diamond tipped saws, dental saws, or drills, which may not always be readily available and risk burning the patient’s skin.
The authors concluded, “Our method used simple equipment that is readily available in most hospitals at all times, took less than 30 seconds to perform, and could be performed by a sole operator without damage to the underlying finger.”
The authors reported no disclosures.