[Occlusion of the arteries of the fingers after hyperextension trauma].
Acute occlusion of digital arteries due to a sport injury A 33 year old female patient with acute ischaemia of the fingers I-II of the right hand was admitted to our emergency unit. She reported that this complete ischaemia had shortly occurred after a sport injury due to an extreme hyperflexion of the right hand in a volleyball match. Four days after this trauma she felt pain and paraesthesia in the right hand. Circular areas of ischaemia were developed with skin colour change to grey and dark blue. The primary measure of the blood pressure by doppler analysis showed no signals in the first and second finger. Initially she received 500 mg Aspirin by intravenous injection. The full therapeutic dose of LMWH related to the weight of the patient was given. On the basis of the short time interval between the occurrence of the symptoms and admission of the patient we decided to perform a so called retrograde intravenous injection. The aim of this therapy was the intraarterial lysis and reperfusion. The blood pressure in all fingers were nearly normal after three days. Daily intravenous transfusion of prostaglandin were given additionally. Necrosis could be prevented as a result of our treatment over seven days. At the end of our therapy only the skin epithelium of the second finger was slightly raised and showed a tendency to desquamation. All other fingers occurred in a normal colour.
Pöhlmann
G
G
Klinik für Innere Medizin III des Klinikums der Friedrich-Schiller-Universität Jena. Guenter.Poehlmann@med.uni-jena.de
Bär
H
H
Siegmund
R
R
Eidner
G
G
Figulla
H R
HR
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000188:drug therapy; D001241:Aspirin / Q000008:administration & dosage; D001265:Athletic Injuries / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis* / Q000188:drug therapy; D005385:Fingers / Q000098:blood supply*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D007511:Ischemia / Q000175:diagnosis* / Q000188:drug therapy
D006495:Heparin, Low-Molecular-Weight; D001241:Aspirin