Long-term clinical outcomes in patients diagnosed with severe digital ischemia

Abstract

Among patients with digital ischemia, systemic disease and hypothenar hammer syndrome were the most frequent aetiologies. In patients with hypothenar hammer syndrome the clinical outcome was remarkably benign, although symptoms may persist with provocation, whereas patients with systemic disease have a high mortality rate.

Digital ischemia: Etiologies and long-term follow up. A cohort study of 323 patients

“…The low rate of recidivism is also in favor of this proximity. Iatrogenic cause was the fourth highest-occurring etiology, in this study, with a rate of 9.6% vs 0 to 2.8% in literature (2,4,9,(12)(13)(14)(15) ; where for 3 of 7 other studies, iatrogenic etiology was not a research focus. The stronger representation, in this study, is linked to a broad recruitment of patients, in critical care units, with more drug-induced iatrogenic UEDI.…”

“…Three of them were among specific patients : cancer-induced UEDI (4), hypothenar hammer syndrome (6), systemic sclerosis (7)). Only two studies were about general follow up of UEDI, both with a limited number of cases (8,9).…”

Ulnar Hammer Syndrome

“…Seven of the 30 studies scored greater than 8. 8,15,16,19,21,23,24 None of the included studies was prospectively designed. Studies were insufficient in quality and homogeneity to combine them in a meta-analysis.…”

“…Seventeen of the 21 studies describe their angiographic findings (Table 3). 9,[11][12][13][14][15]19,20,23,24,26,[28][29][30][31][32][33][34] The most common findings include occlusion of the ulnar artery in the area of the hamate and multiple occlusions of the digital arteries.…”

Critical ischemia of the fingers in an auto mechanic as a result of occupational exposure

“…Right-hand computed tomography angiography (CTA) -volume rendering reconstruction, corkscrewing course of the ulnar artery to the length of about 3 cm thrombosis. The ischemic symptoms described in the literature vary in severity from chronic, manifesting when the hand is challenged by an increased effort, to critical with the presence of resting pain or trophic finger changes, which may lead to amputation of the fingers [2,5,6]. Neurological symptoms (pain, paresthesia, numbness) occur as a result of concomitant ulnar nerve injury.…”