Vol. 7, Issue 2, Part C (2025)

Ring avulsion injuries are uncommon but potentially severe traction injuries of the finger, caused by a sudden longitudinal force on a ring-bearing digit. Damage may range from superficial skin tears to complete degloving or amputation with involvement of tendons, joints and neurovascular bundles. Several classifications, including those of Urbaniak and Nissenbaum, have been proposed to grade tissue damage and circulatory status and to guide the choice between salvage procedures and amputation. Most published lesions follow a true ring-related mechanism. We report an unusual ring avulsion-type injury of the middle finger in a young adult whose digit was suddenly hooked under a horizontal metal stair-rail during a fall, in the absence of any ring. The trauma caused a distal interphalangeal joint-level amputation, with a non-viable distal part and avulsion of the flexor digitorum profundus tendon. In a resource-limited setting without microsurgical facilities, early revision amputation at the distal interphalangeal level was chosen after assessment of tissue viability and discussion with the patient. At short-term follow-up he recovered a painless, stable and mobile stump. This observation shows that, in selected patients and contexts, a carefully planned revision amputation may represent a pragmatic and functionally acceptable option for high-grade ring avulsion-type injuries.