A new class of ring avulsion injuries

Sixteen patients with ring avulsion injuries treated at Loma Linda University over 10 years were reviewed. According to Urbaniak's classification scheme, there were two class I, seven class II, and seven class III injuries. Follow-up functional measurements showed that the grip strength of our class II patients were, on the average, no better than that of the class III patients, even though all of class III patients had amputation revisions. Five class II patients required only venous microvascular repair. We propose to modify Urbaniak's classification to IIC to include only ring avulsion injuries with venous compromise. These patients had excellent functional results, with an average total active motion of 224 degrees.