Complications in the upper extremity following intra-arterial drug abuse.
A retrospective study of drug abuse patients who developed arterial and venous complications in the upper extremity during 2002-2006 was performed. Twenty-two patients were admitted to hospital on 24 occasions over this period for treatment by our hand clinic. The drug most frequently causing complications was midazolam. The predominant clinical findings were increasing pain and loss of sensitivity in the hand, followed by oedema, cyanosis and marbling of the skin. Treatments included brachial block anaesthesia, low molecular weight heparin, embolectomy and fasciotomies. Despite these measures, amputations, mainly of the fingertips, were necessary in 15 patients. Complications in the upper extremity after self-injection by drug addicts are increasing; information and preventive procedures to minimize these complications are important and demanding tasks for health care bodies.
Helsinki University Central Hospital, Department of Hand Surgery, Helsinki, Finland. nina.c.lindfors@hus.fi
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Lindfors
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Vilpponen
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Raatikainen
D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000792:Angiography; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D003161:Compartment Syndromes / Q000503:physiopathology / Q000628:therapy; D003490:Cyanosis / Q000503:physiopathology / Q000628:therapy; D062109:Dermatologic Surgical Procedures; D004487:Edema / Q000503:physiopathology / Q000628:therapy; D017128:Embolectomy; D000071938:Fasciotomy; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use; D008297:Male; D009336:Necrosis; D009407:Nerve Block; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000503:physiopathology / Q000628:therapy; D012867:Skin / Q000473:pathology; D012871:Skin Diseases / Q000503:physiopathology / Q000628:therapy; D015819:Substance Abuse, Intravenous / Q000503:physiopathology*; D013524:Surgical Flaps; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D034941:Upper Extremity / Q000098:blood supply / Q000503:physiopathology* / Q000601:surgery; D014664:Vasodilation; D014665:Vasodilator Agents / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014665:Vasodilator Agents; D006493:Heparin; D010959:Tissue Plasminogen Activator; D016285:Iloprost