[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-455415-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-455415-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","necrotizing-cellulitis-of-the-finger-caused-by-ring-embedment-leading-to-amputation-case-report-and-literature-review","Necrotizing Cellulitis of the Finger Caused by Ring Embedment Leading to Amputation - Case Report and Literature Review","","Constrictive ring embedment can trigger progressive ischemia, tissue necrosis, and infection, yet direct digital amputation from this mechanism is rarely documented. The authors report a 62-year-old woman with five days of right ring finger cellulitis from prolonged ring erosion reaching bone, presenting with pain, fever, weakness, tachycardia, and sepsis. Exam showed crepitus while radiographs showed no subcutaneous air. Due to severe ischemic damage and reperfusion injury risk, she underwent digital amputation. The Braden scale indicated high pressure-ulcer risk.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/necrotizing-cellulitis-of-the-finger-caused-by-ring-embedment-leading-to-amputation-case-report-and-literature-review/455415/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/necrotizing-cellulitis-of-the-finger-caused-by-ring-embedment-leading-to-amputation-case-report-and-literature-review/455415.png","ImageObject",300,407,{"name":42,"@type":43},"MrHarris58","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-02","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",15,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How can constrictive ring embedment lead to severe infection and tissue loss?","Question",{"text":63,"@type":64},"Constrictive ring embedment can cause progressive ischemia, tissue necrosis, and infection by promoting capillary occlusion and impaired bacterial clearance and wound healing. Reperfusion injury can further complicate management.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What were the key clinical findings in the reported case?",{"text":68,"@type":64},"The patient had a five-day history of right ring finger cellulitis with pain, fever, weakness, and tachycardia with signs of sepsis. Physical exam revealed crepitus, while radiographs showed no subcutaneous air.",{"name":70,"@type":61,"acceptedAnswer":71},"Why was digital amputation pursued in this case?",{"text":72,"@type":64},"The severity of ischemic tissue damage and the risk of reperfusion injury required transfer to orthopedics for digital amputation rather than delaying definitive treatment.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},455415,1791227537,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":102,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":55,"preview_page_count":4},687212988360,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Review began 04/01/2025  \nReview ended 11/30/2025  \nPublished 12/08/2025  \n© Copyright 2025  \nGuha et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98746  \nOpen Access Case Report  \nNecrotizing Cellulitis of the Finger Caused by Ring Embedment Leading to Amputation: A Case Report and Literature Review  \nShreya Guha 1, Manya Bali 1 , Zohaer Muttalib 1 , Eldo Frezza 2  \n1. Medical School, California Northstate University College of Medicine, Elk Grove, USA 2. Surgery, California Northstate University College of Medicine, Elk Grove, USA  \nCorresponding author: Eldo Frezza, [eldo.frezza@cnsuedu.onmicrosoft.com](eldo.frezza@cnsuedu.onmicrosoft.com)  \nAbstract  \nConstrictive ring embedment can cause progressive ischemia, tissue necrosis, and infection. Although embedded rings have been reported, digital amputation as a direct result is rarely documented.  \nThe authors present the case of a 62-year-old woman who presented to the emergency department with a five-day history of right ring finger cellulitis secondary to prolonged ring erosion extending to the bone. She reported pain, fever, and weakness, and was tachycardic with signs of sepsis. A physical exam revealed crepitus, though radiographs showed no subcutaneous air. Given the severity of ischemic tissue damage and the risk of reperfusion injury, the patient was transferred to the orthopedic service for digital amputation.  \nThe Braden scale, a measurement tool for pressure ulcer risk, identified her as high-risk for pressure ulcers, emphasizing the need for early intervention. Prolonged ring pressure had led to capillary occlusion, ischemia, and necrosis, creating an environment for bacterial infection. Ischemia-driven hypoxia further impaired bacterial clearance and wound healing, while reperfusion injury complicated management.  \nThis case highlights the importance of early recognition and intervention in ring-related ischemic injuries. Clinicians should be aware of the potential for severe vascular compromise, infection, and reperfusion injury in constrictive ring embedment.  \nCategories: Emergency Medicine, Infectious Disease, Orthopedics  \nKeywords: digit amputation, infection, ischemia, necrotizing cellulitis, oxygen therapy, pressure ulcer, reperfusion injury, tissue necrosis  \nIntroduction  \nNecrotizing cellulitis (NC) is a rare but serious bacterial infection of the skin that can lead to tissue destruction, severe inflammation, and potential systemic spread. NC most commonly presents in patients with pre-existing conditions that compromise immunity or tissue perfusion. Common risk factors for NC include diabetes mellitus, peripheral vascular disease, chronic kidney disease, immunosuppression, chronic wounds or ulcers, recent surgeries, and IV drug use, among other factors. Necrotizing fasciitis is rapidly progressive and is characterized by high morbidity and mortality rates. Common presenting symptoms include localized pain (93 .8%), swelling (80 .6%), and erythema (79 .5%), often accompanied by systemic signs such as fever (55%) and hypotension in advanced stages. The condition carries a mortality rate ranging from 20% to 40%, with delays in diagnosis significantly increasing the risk of death [1] . NC is most commonly caused by Clostridium spp., Group A Streptococcus, and mixed anaerobic and facultative bacterial species [2] .  \nIt can occur through a variety of mechanisms, including a break in the skin, puncture wounds, and ischemia, which can all lead to necrosis and gangrene of the affected area. Necrotizing fasciitis can develop rapidly, often within 12-24 hours, and presents with spreading erythema, warmth, and swelling in the affected area.  \nIt progresses with blistering, bullae, and skin necrosis. It is also associated with severe","cbCaicDkaXSUSYBo","https://ap.wps.com/l/cbCaicDkaXSUSYBo","pdf",1513400,"English","# Abstract\n# Introduction\n## Necrotizing cellulitis and necrotizing fasciitis overview\n## Risk factors and clinical presentation\n## Diagnosis and treatment principles","[{\"question\":\"How can constrictive ring embedment lead to severe infection and tissue loss?\",\"answer\":\"Constrictive ring embedment can cause progressive ischemia, tissue necrosis, and infection by promoting capillary occlusion and impaired bacterial clearance and wound healing. Reperfusion injury can further complicate management.\"},{\"question\":\"What were the key clinical findings in the reported case?\",\"answer\":\"The patient had a five-day history of right ring finger cellulitis with pain, fever, weakness, and tachycardia with signs of sepsis. Physical exam revealed crepitus, while radiographs showed no subcutaneous air.\"},{\"question\":\"Why was digital amputation pursued in this case?\",\"answer\":\"The severity of ischemic tissue damage and the risk of reperfusion injury required transfer to orthopedics for digital amputation rather than delaying definitive treatment.\"}]","Necrotizing Cellulitis of the Finger Caused by Ring Embedment Leading to Amputation - Case Report and Literature Review | PDF",1790742818]