Flatt A E
J Hand Surg Am. 1980 Nov;5(6):550-6. doi: 10.1016/s0363-5023(80)80104-3.
A very distal sympathectomy at the level of the origin of the proper digital arteries has been devised. Four men and four women have been operated on for digital vascular insufficiency due to frostbite, crush injuries, scleroderma, and Raynaud's disease. The operation is done through a palmar approach and the adventitia removed, over a length of 3 to 4 mm, from the proper digital arteries distal to the junction of the distal perforating artery with the common digital artery. Three frostbite victims have done well; their ulcers have healed, pain symptoms have improved, and a skin temperature rise of 1.5 degrees to 2.5 degrees F has persisted over a 17-year follow-up. Two crushed fingers have shown some, but not impressive, permanent symptomatic improvement. Three women had four operations for Raynaud-type disease. Two of the women, 40 and 41 years of age, showed a permanent skin temperature rise of only 2 degrees and 1 degree F, respectively. They showed significant, but not total, pain relief. The third woman, 22 years of age, had atrophic, curled index and thumb nails. After sympathectomy, the nails grew normally, there was significant pain relief, and the patient showed a permanent 3 degrees F rise in skin temperature.
已设计出一种在指固有动脉起始水平进行的非常远端的交感神经切除术。4名男性和4名女性因冻伤、挤压伤、硬皮病和雷诺病接受了手术治疗，以解决手指血管功能不全问题。手术通过掌侧入路进行，在远侧穿支动脉与指总动脉交界处远端的指固有动脉上，去除3至4毫米长度的外膜。3名冻伤患者恢复良好；他们的溃疡已愈合，疼痛症状有所改善，在长达17年的随访中，皮肤温度持续升高1.5华氏度至2.5华氏度。2根挤压伤手指有一定程度的永久性症状改善，但效果不显著。3名女性因雷诺氏病接受了4次手术。其中两名分别为40岁和41岁的女性，皮肤温度仅分别永久性升高2华氏度和1华氏度。她们的疼痛有显著缓解，但未完全消除。第三名22岁的女性，食指和拇指指甲萎缩、卷曲。交感神经切除术后，指甲正常生长，疼痛显著缓解，患者皮肤温度永久性升高3华氏度。
