A new technique in the management of the ring avulsion injury

There is universal agreement that microvascular repair is the only way to salvage class II ring avulsion injuries. We report on two patients who sustained this type of injury and were treated successfully by extensive fasciotomy. The circulatory compromise following class II ring injuries deteriorates rapidly due to the tourniquet-like effect by the progressive swelling of the soft tissue envelope. Fasciotomy eliminates this effect and allows adequate inspection of the neurovascular bundles. Microvascular repair is still feasible if considered necessary.