Resolution of Ring Tourniquet with a High-speed Dental Drill in a Remote Pacific Island Clinic

Ring tourniquet syndrome is a strangulation injury, usually at the proximal finger or toe, caused by a rigid circular metal object. The resulting ischemia can lead to necrosis, permanent nerve and/or tissue damage, and amputation of the digit. There are numerous non-cutting methods for removing the ring; however, edema, fractures, or arthrosis of the site can occasionally make these techniques difficult or impossible. While ring cutters, manual or electric, are the first choice for resolving ring tourniquet caused by metal jewelry, these tools are not readily available everywhere. Resolution of ring tourniquet with high-speed rotary tools has been previously described as a tertiary method. Here we describe the use of a high-speed dental tool as a primary ring cutting method for the resolution of ring tourniquet in a patient with significant edema in a low-resource setting.