Secondary Logo

Journal Logo

The Caterpillar Technique for Removal of a Tight Ring

Section Editor(s): Shafer, Steven L.St. Laurent, Carla MD

doi: 10.1213/01.ane.0000239052.17287.d0
Letters to the Editor: Letters & Announcements

Department of Anesthesiology; University of California Irvine Medical Center; Orange, CA;

Back to Top | Article Outline

To the Editor:

Many techniques have been described in the literature for the removal of a tight ring (1–13). Suture, glove, rubber band, nylon tape, ribbon gauze, and paper clips have all been recommended for the nondestructive removal of a ring that is “stuck.”

I have been using the “caterpillar technique” for more than 10 years with remarkable success. It has worked when suture and other methods have failed. With generous lubricant and this method, a ring that has not budged in years can be removed in seconds, usually to the surprise of the patient and operating room staff.

First, coat the ring and the entire finger with whatever lubricant is available. Hand lotion and KY jelly work just fine. Press upward on the ring. While maintaining firm, direct pressure, swing the top portion of the ring forward. Release pressure. Press downwards on the ring and swing the bottom portion of the ring towards the finger tip. Do not be afraid to press firmly. There may be some discomfort at the proximal interphalangeal joint. Reassure the patient. The ring will soon slip off entirely once this last resistance is passed. Please refer to Figure 1 for more details.

Figure 1

Figure 1

Carla St. Laurent, MD

Department of Anesthesiology

University of California Irvine Medical Center

Orange, CA

Back to Top | Article Outline


1. Belliappa PP. A technique for removal of a tight ring. J Hand Surg 1989;14:127.
2. Rubio PA. Letter to the editor. Am J Surg 1987;153:A42.
3. Mizrahi S, Lunski I. Am J Surg 1986;151:412–3.
4. Soichiro I, Akazawa S, Fukuda H, Shimizu R. Another simple method for ring removal. Anesthesiology 1995;83:1133–4.
5. Clarke AC, Spencer RF. Ring removal from the injured or swollen finger. J R Coll Surg Edinb 1991;36:59.
6. McElfresh EC, Peterson-Elijah RC. J Hand Surg [Br] 1991;16:225–6.
7. Hiew LY, Juma A. A novel method of ring removal from a swollen finger. Br J Plast Surg 2000;53:173–4.
8. Paterson P, Khanna A. A novel method of ring removal from a swollen finger. Br J Plast Surg 2001;54:182.
9. Thiagarajan M. An improved method of ring removal. J Hand Surg [Br] 1999;24: 118–9.
10. Leider M. Removal of a ring from a swollen finger without injuring the ring. J Dermatol Surg Oncol 1980;6:298–9.
11. Witz R. Ring removal. Nurse Pract 2002;27:54.
12. Mullett ST. Ring removal from the oedematous finger. An alternative method. J Hand Surg [Br] 1995;20:496.
13. Cresap CR. Removal of a hardened steel ring from an extremely swollen finger. Am J Emerg Med 1995;13:318–20.
© 2006 International Anesthesia Research Society