M.B. is a 51-year-old right-handed tool dye manufacturer who was working on an engine block when a thick steel band completely encircled his left middle, ring and little fingers with impending neurovascular compromise, especially of the left middle finger. The patient sustained an amputation of the ulnar half of the distal phalanx of his left index finger with the amputated part visible within the loop of the steel band. There was a laceration to the central slip of the left middle finger and soft tissue injury to the volar and dorsal aspects of the left little finger.
Following extrication of the steel band using an Ambrush diamond drill, the amputated ulnar half of the distal phalanx of the left index finger was reattached as a composite graft with complete survival, the central slip to the left middle finger was repaired and the soft tissue reconstructed. MB had an excellent aesthetic and functional result.