Long-term recovery following surgical treatment for ulnar artery occlusion

Zimmerman, Neal B.; Zimmerman, Sheryl; McClinton, Michael A.; Wilgis, E.F. Shaw; Koontz, Cherry; Buehner, Jane Wallace

doi:10.1016/0363-5023(94)90218-6

Cited by 24 publications

(24 citation statements)

References 11 publications

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“…19 Seven of the 8 reconstructions remained patent. Most patients in both groups had improved, but had persistent symptoms.…”

Section: Clinical Datamentioning

confidence: 97%

“…A DBI of less than 0.7 indicates that arterial inflow to the digit is inadequate and arterial reconstruction is indicated. 19 If vascular studies are not available in the operating room, rapidity of flow return to the affected fingers can be used as an estimate of arterial inflow. If refill occurs in less than 6 seconds after release of the tourniquet, blood supply is probably adequate.…”

Section: Diagnostic Testingmentioning

confidence: 99%

“…19 Measurements are performed after the ulnar artery is resected. Although the DBI is measured in multiple digits, insufficient flow to any single digit mandates reconstruction of the ulnar artery.…”

Section: Diagnostic Testingmentioning

confidence: 99%

See 2 more Smart Citations

Treatment of Symptomatic Ulnar Artery Occlusion

Netscher

Janz

2008

The Journal of Hand Surgery

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“…19 Seven of the 8 reconstructions remained patent. Most patients in both groups had improved, but had persistent symptoms.…”

Section: Clinical Datamentioning

confidence: 97%

Section: Diagnostic Testingmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Symptomatic Ulnar Artery Occlusion

Netscher

Janz

2008

The Journal of Hand Surgery

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“…Ligation, performed to prevent further thromboembolism, requires proven adequate collateral circulation and some have used a DBI of 0.7 as the cut point in determining simple ligation versus surgical reconstruction. 24 Although the nutritional benefits of revascularization would seem obvious, Lifchez's retrospective data suggest a more complex pathophysiology. 25 In a group of 14 patients treated with surgical reconstruction, late postoperative occlusion rates were greater than 40%.…”

Section: Management Of Hhsmentioning

confidence: 99%

Hypothenar hammer syndrome: A case and brief review

2011

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A 51-year-old, right-handed, Caucasian, male factory mechanic with an underlying history of active tobacco abuse, hypertension and hyperlipidemia, awoke with severe, throbbing, left hand pain. His hand felt 'ice-cold'; 'like someone pulled my fingernails out'. He denied previous trauma of the involved upper limb or hand. He denied similar past symptomatology. Home medications included zolpidem, simvastatin, losartan, celecoxib, amitriptyline and diltiazem. His work activities were physically demanding, involving heavy use of his hands. He described a history of frequently using his left hand for pounding during previous employment as a farmer. For the previous 6 years, he had been employed as a factory mechanic, requiring less overall use of the left hand as a hammer, though he did still use this technique. Pounding activities using the right hand were much less frequent.He sought initial evaluation in the emergency department where Raynaud's phenomenon was suspected and a trial of cilostazol started. Symptoms, however, progressed to dusky, cyanotic-appearing 2nd, 3rd, 4th, and, to a lesser extent, 5th digits ( Figure 1) with worsening pain and hypersensitivity. Early signs of tissue loss were noted at the tip of the long finger (Figure 2 AbstractHypothenar hammer syndrome is an uncommon cause of upper-extremity ischemia that is often overlooked in the absence of a thorough occupational and recreational history. Importantly, it is a reversible cause of hand ischemia that, if missed, can lead to significant morbidity and even amputation. The occupational ramifications and quality of life of those affected can be significant. Its relative rarity, set against the ubiquitous use of the hand as a 'hammer' is noteworthy. Several other causes of hand ischemia can present similarly; therefore, consideration of other etiologies must be thoroughly investigated. Key distinguishing clinical features, in addition to a detailed occupational and recreational history, may include characteristic sparing of the thumb, the absence of a hyperemic phase in 'Raynaud's phenomenon', and a positive Allen's sign. Both non-invasive and invasive diagnostic studies, including bilateral upper-limb segmental pulse volume recordings (PVR), arterial duplex examination, and upper-extremity angiography, are complementary to a thorough history and physical examination. Optimal management strategies are not well defined because of its rarity and resultant lack of quality, evidence-based data. Though most cases can be successfully managed non-operatively, micrographic arterial reconstruction may be limb saving in severe or recalcitrant cases. Newer, experimental strategies including selective sympathetic blockage using botulinum toxin A have been reported in a few recalcitrant cases. The brief case description illustrates the typical presentation and potential treatment strategies employed in a difficult case. A review of relevant literature is also presented.

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“…5,7 Therefore, treatment remains controversial. [2][3][4][5][6][7][8][9][10] The purpose of this study is to report the outcome of ulnar artery reconstruction with reverse interpositional vein grafting (RIVG) for posttraumatic ulnar artery and superficial arch thrombosis with a minimum of 2 years follow-up.…”

mentioning

confidence: 99%