{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:08:17Z","timestamp":1790014097668,"version":"4.0.1"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 41-year-old man removed a tungsten carbide ring from his left index finger by cutting it off with a high-speed metal burr. The patient presented two days later with a pink and perfused left index finger with circumferential dry gangrene along the area of the ring, active flexor and extensor tendon excursion, and decreased sensation distally. Within 24 hours, the wound developed into wet gangrene and diffuse cyanosis requiring amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>After reviewing previously documented methods to remove tungsten carbide rings, the authors conclude clinicians should be cognizant of the potential complications associated with the use of a high-speed metal burr.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.23.00467","type":"journal-article","created":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T01:47:56Z","timestamp":1715996876000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Digital Thermal Necrosis Resulting in Amputation After Removing a Tungsten Carbide Ring With a High-Speed Metal Burr"],"prefix":"10.2106","volume":"14","author":[{"given":"Ernesto S.","family":"Quinto","sequence":"first","affiliation":[{"name":"VCME Orthopedic Surgery Residency, Modesto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3453-3767","authenticated-orcid":false,"given":"John M.","family":"Dowbak","sequence":"additional","affiliation":[{"name":"VCME Orthopedic Surgery Residency, Modesto, California"},{"name":"Division of Orthopedic Surgery, San Joaquin General Hospital, French Camp, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,4]]},"reference":[{"issue":"10","key":"bib1-20240805","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1016\/j.ajem.2013.07.027","article-title":"A comparison of two techniques for tungsten carbide ring removal","volume":"31","author":"Gardiner","year":"2013","journal-title":"Am J Emerg Med."},{"issue":"1","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jemermed.2011.07.032","article-title":"A method for the removal of tungsten carbide rings","volume":"43","author":"Allen","year":"2012","journal-title":"J Emerg Med."},{"key":"bib3-20240805","first-page":"8164524","article-title":"Removal of a tungsten carbide ring from the finger of a pregnant patient: a case report involving 2 emergency departments and the internet","volume":"2016","author":"Moser","year":"2016","journal-title":"Case Rep Emerg Med."},{"issue":"1","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1136\/jramc-2013-000007","article-title":"Technical tip: removal of tungsten carbide rings","volume":"159","author":"McCarver","year":"2013","journal-title":"J R Army Med Corps."},{"issue":"9","key":"bib5-20240805","doi-asserted-by":"crossref","first-page":"e701","DOI":"10.1016\/j.bjps.2010.03.058","article-title":"Removal of a tungsten carbide wedding ring with a diamond tipped dental drill","volume":"63","author":"Ricks","year":"2010","journal-title":"J Plast Reconstr Aesthet Surg."},{"issue":"5","key":"bib6-20240805","doi-asserted-by":"crossref","first-page":"E128","DOI":"10.1016\/j.bjps.2011.12.024","article-title":"Removal of a titanium ring using a dental saw","volume":"65","author":"Chambers","year":"2012","journal-title":"J Plast Reconstr Aesthet Surg."},{"issue":"9","key":"bib7-20240805","doi-asserted-by":"crossref","first-page":"529","DOI":"10.12968\/hmed.2011.72.9.529","article-title":"Removal of a titanium alloy ring","volume":"72","author":"Bleibleh","year":"2011","journal-title":"Br J Hosp Med."},{"issue":"9","key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"P1084.E3","DOI":"10.1016\/j.ajem.2007.03.006","article-title":"Titanium alloy ring crush injury","volume":"25","author":"Kapickis","year":"2007","journal-title":"Am J Emerg Med."},{"issue":"1","key":"bib9-20240805","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1080\/08897077.2021.1903654","article-title":"Stimulant use for self-management of pain among safety-net patients with chronic non-cancer pain","volume":"43","author":"Beliveau","year":"2022","journal-title":"Subst Abus."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.23.00467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:43:12Z","timestamp":1787751792000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.23.00467"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.23.00467","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}