Zheng Xiaoyu, Yang Yang, Jin Hongliang, Chen Yiguo, Wang Wei
School of Clinical Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, China.
Department of Orthopedics, The People's Hospital of Yubei District of Chongqing City, Chongqing, China.
Am J Case Rep. 2025 Aug 29;26:e948422. doi: 10.12659/AJCR.948422.
BACKGROUND Raynaud syndrome, also known as Raynaud phenomenon, is characterized by vasospasm of small blood vessels supplying the digits and is usually reversible but can rarely result in severe and irreversible ischemia. Periosteal distraction osteogenesis is a technique that creates a space between the periosteum and the bone surface to stimulate the formation of new bone. This report describes a 67-year-old woman with a 10-year history of Raynaud syndrome presenting with ischemia and gangrene of the right index and middle fingers managed with radial periosteal distraction osteogenesis. CASE REPORT Ten years earlier, the patient received a diagnosis of Raynaud syndrome and had been taking nifedipine sustained-release tablets orally for symptom control ever since. Two weeks before presentation, she successfully recovered from septic shock through the rescue of the Intensive Care Unit. One week before presentation, the patient experienced an aggravation of pain in both fingers. Her distal ends of the right index and middle fingers became darker. After performing the relevant examinations, she received a diagnosis of Raynaud syndrome (bilateral) and gangrene of the right finger. Following the exclusion of surgical contraindications, radial periosteal distraction was performed. The periosteum was continuously distracted after the operation. During follow-up, the patient's gangrene gradually progressively healed, and the pain in both hands markedly diminished. CONCLUSIONS This report supports recent studies that have shown the potential for periosteal distraction osteogenesis in the management of cases of severe and irreversible Raynaud disease of the digits.
背景 雷诺综合征，又称雷诺现象，其特征是供应手指的小血管发生血管痉挛，通常是可逆的，但很少会导致严重且不可逆的缺血。骨膜牵张成骨术是一种在骨膜和骨表面之间创造空间以刺激新骨形成的技术。本报告描述了一名67岁女性，有10年雷诺综合征病史，出现右手示指和中指缺血及坏疽，采用桡骨骨膜牵张成骨术进行治疗。病例报告 10年前，该患者被诊断为雷诺综合征，此后一直口服硝苯地平缓释片以控制症状。就诊前两周，她通过重症监护病房的抢救成功从感染性休克中康复。就诊前一周，患者双手手指疼痛加重。右手示指和中指远端颜色变深。进行相关检查后，她被诊断为双侧雷诺综合征和右手手指坏疽。排除手术禁忌证后，进行了桡骨骨膜牵张术。术后持续进行骨膜牵张。随访期间，患者的坏疽逐渐愈合，双手疼痛明显减轻。结论 本报告支持了最近的研究，这些研究表明骨膜牵张成骨术在治疗严重且不可逆的手指雷诺病病例中具有潜力。
