Zhou Zhegang, Yu Longbiao, Meng Fanbin, Wen Jingjing, Xiao Yingfeng, Shan Huiming, Wan Shengxiang, Zeng Hui, Yu Fei
From the Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China.
Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China.
Plast Reconstr Surg Glob Open. 2024 Jul 16;12(7):e5978. doi: 10.1097/GOX.0000000000005978. eCollection 2024 Jul.
A 50-year-old man was admitted to the hospital with a chief complaint of long-standing cold-induced numbness in the fingers for more than a year, accompanied by persistent hand pain and fingertip ulceration for 3 months. On physical examination, radial and ulnar artery pulsation was absent in both limbs, and pale skin color, low skin temperature, and limited finger range of motion were noted. Gangrene was detected in the fingertips of the left index and middle fingers, and the right middle and ring fingers. The patient was diagnosed with bilateral arterial occlusion and vibration white finger. Upon admission, the patient underwent an intervention surgery on the right side. Subsequently, transplantation of the descending branches of the left and right lateral femoral circumflex arteries was performed to restore blood flow in the bilateral radial arteries. Additionally, debridement was conducted without shortening after the surgical procedure, the patient received anticoagulation, anti-inflammatory, and symptomatic treatment. The bilateral finger skin temperature increased by 3 °C postoperatively, and the accompanying pain and numbness were alleviated. The wound healed 1 month after surgery, and no recurrence of pain or ulcer was reported during the 1-year follow-up period. Eventually, his hand function recovered, without any impact on the vascular donor site.
一名50岁男性因长期手指冷诱导麻木1年余入院,伴有持续手部疼痛和指尖溃疡3个月。体格检查发现双上肢桡动脉和尺动脉搏动消失,皮肤苍白、温度低,手指活动范围受限。左示指和中指、右中指和环指指端出现坏疽。患者被诊断为双侧动脉闭塞和振动性白指。入院后,患者接受了右侧介入手术。随后,进行了左右旋股外侧动脉降支移植以恢复双侧桡动脉血流。此外,手术后进行了清创且未缩短手指,患者接受了抗凝、抗炎及对症治疗。术后双侧手指皮肤温度升高3℃,伴随的疼痛和麻木症状减轻。术后1个月伤口愈合,1年随访期间未报告疼痛或溃疡复发。最终,他的手部功能恢复,对血管供区无任何影响。