Jeong Yeon Jin, Park Seong Hyuk, Lee Jun Yong
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Medicine (Baltimore). 2017 Apr;96(14):e6324. doi: 10.1097/MD.0000000000006324.
Slowly progressive hand ischemia is mostly associated with medical illness such as vasculitis, and in patients with smoking history, Buerger disease is often considered first. However, despite the very low incidence of vascular anatomical anomalies, they can lead to hand ischemia. And if there is no consideration for them, proper treatment cannot be selected.
A 42-year-old male smoker presented with a slowly progressing 5th fingertip necrosis following blunt trauma.
Angiography revealed congenital hypoplasia of ulnar artery, and excluded Buerger disease or hypothenar hammer syndrome.
We reconstructed the necrotic fingertip using a 2nd toe pulp free flap to reflect the patient's need.
In this case report, the authors emphasize that the possibility of anatomical anomaly should be considered as a cause of the ischemia. Vascular imaging should be undertaken to investigate the cause of ischemia of the hand.
缓慢进展性手部缺血大多与血管炎等内科疾病相关，对于有吸烟史的患者，常首先考虑血栓闭塞性脉管炎。然而，尽管血管解剖异常的发生率极低，但它们可导致手部缺血。若未考虑到这些异常，就无法选择恰当的治疗方法。
一名42岁男性吸烟者，在钝器伤后出现第5指尖缓慢进展性坏死。
血管造影显示尺动脉先天性发育不全，排除了血栓闭塞性脉管炎或小鱼际锤状指综合征。
我们采用第2趾趾腹游离皮瓣修复坏死指尖，以满足患者需求。
在本病例报告中，作者强调应将解剖异常视为缺血的病因之一。应进行血管成像检查以探究手部缺血的原因。
