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A new class of ring avulsion injuries
D J Weil1, V E Wood, G K Frykman
1Department of Orthopaedic Surgery, Loma Linda University Medical Center, Calif. 92350.
The Journal of Hand Surgery
|July 1, 1989
Summary
Ring avulsion injuries treated with venous microvascular repair showed excellent functional results. A modified classification (IIC) is proposed for these specific venous compromise cases.
Area of Science:
- Orthopedics
- Microsurgery
- Trauma Surgery
Background:
- Ring avulsion injuries are severe upper extremity trauma.
- Urbaniak's classification categorizes these injuries from I to III.
- Current classifications may not fully differentiate outcomes based on venous compromise.
Purpose of the Study:
- To review outcomes of ring avulsion injuries.
- To evaluate the effectiveness of venous microvascular repair.
- To propose a modification to Urbaniak's classification.
Main Methods:
- Retrospective review of 16 patients with ring avulsion injuries.
- Classification of injuries using Urbaniak's scheme.
- Functional outcome assessment including grip strength and total active motion.
Main Results:
- Seven class II and seven class III injuries were identified.
- Class II patients' grip strength was comparable to class III patients.
- Five class II patients undergoing venous microvascular repair had excellent functional results (224° total active motion).
Conclusions:
- Venous compromise in ring avulsion injuries (proposed class IIC) can achieve excellent outcomes with specific repair.
- A modified classification incorporating venous compromise is warranted.
- Venous microvascular repair is a viable option for select ring avulsion injuries.