title: Temporary arterial stenting in a full-house spaghetti wrist injury in a remote rural setting: benefit for hand perfusion or risk of increased morbidity?
abstract: We report a case of temporary arterial plastic tube stenting of the ulnar and radial artery in a complete spaghetti wrist injury in a remote rural setting. Exploration in a specialist centre 18 h postinjury revealed that the tubes were clotted off with adjacent thrombi but hand perfusion was maintained. Intimal damage required vein grafting of both arteries 24 h postinjury. Hand perfusion was not compromised at follow-up. This case highlights that arterial hand perfusion can be maintained without the ulnar and radial artery. Arterial manipulation and tube insertion outside a specialist centre bears the risk of increased morbidity and potential microembolism and must therefore not be attempted.
authors.affiliation: Department of Orthopaedics, Royal Perth Hospital, Perth, Western Australia, Australia. stef11bau@yahoo.co.uk
authors.forename: Stefan
authors.initials: S
authors.lastname: Bauer
authors.forename: James
authors.initials: J
authors.lastname: Savundra
mesh_terms: D000328:Adult; D004617:Embolism / Q000209:etiology*; D006780:Hospitals, Rural; D006801:Humans; D008297:Male; D017534:Radial Artery / Q000293:injuries* / Q000601:surgery*; D012039:Regional Blood Flow; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors; D017535:Ulnar Artery / Q000293:injuries* / Q000601:surgery*; D014954:Wrist Injuries / Q000601:surgery*