Digital amputation caused by climbing-rope entanglement

Digital avulsions and amputations are not uncommon in outdoor activities. Rope entanglement is often the cause, though specific descriptions of the mechanism of injury have not been reported. We report a common scenario where entanglement during a fall resulted in an amputation injury. Although any roping activity may cause a loop formation leading to digital entrapment and subsequent amputation injury, activities involving soft and loose ropes may increase the chances of injury. Rope slack is to be avoided to minimize the likelihood of entanglement. This case report describes a digital amputation during an indoor climbing incident and also describes a possible mechanism for such injuries.