AI Article Synopsis
- A study examined 12 patients with incomplete amputation of fingers and hands who were initially treated without vessel repair, leading to discoloration and necrosis during follow-up.
- The patients experienced a mean warm ischaemic time of 53 hours and underwent delayed revascularization, which included different surgical techniques like artery anastomosis and vein grafting.
- Out of the 12 cases, 8 achieved complete survival of the affected digits, while 4 experienced total necrosis and required revision amputation, indicating that some patients can benefit from delayed revascularization despite long warm ischaemic time.
Article Abstract
We report the fate of neglected vascular injury in cases of incomplete amputation of the digits and hand after delayed revascularization. Twelve patients underwent primary bone fixation, tendon or skin repair for hand injuries without vessel repair despite ischaemic findings. There was discoloration or necrosis of the fingertips during follow-up examination and the patients were referred to us for treatment. The mean warm ischaemic time was 53 hours (range 17-120). Delayed revascularization was performed with end-to-end anastomosis of the digital arteries in eight and vein graft in four cases. Digital nerves were repaired in four cases and flexor tendons in two cases. Of the 12 cases, eight cases showed complete survival. However, in four patients, complete necrosis of the fingers occurred, with one finger surviving partially. Revision amputation was performed in the four cases where necrosis occurred. We conclude that neglected vascular injury associated with incomplete amputation of digits and hands can be overcome in some patients by delayed revascularization even after prolonged warm ischaemic time. IV.
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| http://dx.doi.org/10.1177/1753193419857244 | DOI Listing |
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