An unusual log-splitter injury leading to radial artery thrombosis, ulnar artery laceration, and scapholunate dissociation.
A log splitter is a gasoline- or diesel-powered machine that uses a hydraulic-powered cutting wedge to do the work of an axe. Log-splitter injuries that do not result in amputation of digits or limbs are uncommon and not well described in the literature. We present a unique case of a patient who sustained a log-splitter injury that resulted in thrombosis of the radial artery and avulsion laceration of the ulnar artery leading to acute hand ischemia, in addition to scapholunate ligament disruption leading to a DISI deformity. In this case, thrombolytic therapy was contraindicated and surgical revascularization was the best possible treatment option. Our case illustrates the pitfalls of using this modality in a crush injury, since the use of thrombolytics in this instance would have resulted in severe hemorrhage. An important clinical caveat is the potentially misleading arteriographic diagnosis of thrombosis and/or spasm.
Spock
Christopher R
CR
Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, Connecticut 06520-8062, USA.
Salomon
Jeffrey C
JC
Narayan
Deepak
D
D000062:Accidents, Occupational; D000328:Adult; D016468:Forestry; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis* / Q000601:surgery*; D017534:Radial Artery / Q000293:injuries / Q000601:surgery*; D013927:Thrombosis / Q000175:diagnosis* / Q000601:surgery*; D017535:Ulnar Artery / Q000293:injuries* / Q000601:surgery*; D014954:Wrist Injuries