An Improved Method of Ring Removal
A number of techniques exist for the removal of rings from swollen fingers. An improved method is described using ribbon gauze and a paper clip. It is cheap, quick and effective and can be used in the presence of minor lacerations and abrasions.
A technique for removal of a tight ring
its shape ovoid. This elevates the ring from the oedematous volar skin and allows a McDonald elevator to be inserted (Fig. 2). The ring is then cut with a Steinmann pin cutter and removed (Fig. 3). The whole procedure takes less than a minute. The mechanical efficiency of the Steinmann pin cutter has helped us cut every one of five rings encountered in a period of one month. The McDonald elevator prevents any inadvertent damage to skin. We have found this method to be always successful. In less severe cases, it is possible to slip a McDonald elevator beneath the ring without compressing it first, and then cut the ring with the pin cutter. There should be no danger of nerve or blood vessel damage with side-to-side compression of the ring as the neurovascular bundles are situated antero-laterally. Compression of the ring from side-to-side displaces the neurovascular bundles in a palmar direction where more space is available to accommodate the neurovascular bundles, because the ovoid shape of the ring has enlarged its antero-posterior dimension. In any case, the duration of compression is only for a few seconds as it is immediately relieved by cutting the ring.
CHANGES DUE TO TRAUMA IN THE FAT PLANE OVERLYING THE PRONATOR QUADRATUS MUSCLE: A RADIOLOGIC SIGN.
The radiologist usually has no difficulty identifying fractures of the lower ends of the radius and ulna. There are instances, however, in which there is no displacement of fragments and subtle fractures may be overlooked. It has been observed that a fat plane just anterior to the lower ends of the radius and ulna consistently undergoes alterations from trauma, and sometimes it is easier to appreciate the changes in this fat plane than in the bones themselves. This report concerns identification of the fat plane and a review of the author's experiences in children and adults. The Pronator Plane Radiologic Sign Figure 1, A illustrates a normal lateral projection of the wrist of a twelve-year-old boy, with arrows outlining a linear fat plane. This fat has a gentle convex curve just anterior to the lower one-sixth of the radius and ulna and is seen in true lateral projections of the wrist in almost all normal subjects from premature infants to persons of advanced age. The right and left sides are usually sym...