“A case of spanner in the works, removed from a finger, using a dental bur”—an “image” to be submitted to the Emergency Medical Journal

Removal of circumferential objects from the digits is frequently undertaken to prevent or manage tourniquet effect. We report a case of a ring spanner, defiant to remove by traditional methods, removed using a dental bur.

A NSK high speed air turbine hand piece was used with a taper coarse grit diamond bur to cut through the steel spanner (fig 1). Automatic water irrigation through the hand piece was used to prevent heat build up. The metal skin protector of a standard ring cutter was placed beneath the spanner to protect the finger when approaching the full thickness of the spanner. The spanner was divided in two locations with ease using the dental bur, and was pain free, requiring no local anaesthetic. We believe this novel method to be safe, painless, and advocate this for cases in which the circumferential object is composed of hard metal.

Figure 1 A high speed turbine hand piece with a taper coarse grit diamond bur cutting through a steel spanner