title: Vascular anomalies of the hand and wrist.
abstract: Vascular malformations of the hand and wrist are uncommon. They develop from aberrations in angiogenic signaling during vascular development. Unlike hemangiomas, which are characterized by biphasic growth and slow spontaneous involution, vascular malformations continue to grow proportionally with the child. Management is dictated by classification of the vascular malformations, which is based on flow characteristics (ie, low, high) and predominant cell type (ie, venous, lymphatic, capillary, combined, arteriovenous). Initial management is conservative, with the goal of providing relief from pain and swelling. Sclerotherapy, laser treatment, and arterial embolization may be beneficial in well-selected patients. Surgery is indicated in cases of persistent pain and uncontrolled limb swelling leading to functional impairment and/or neurologic compression. The goals of surgery are to excise as much of the lesion as possible while avoiding injury to adjacent nerves, minimizing blood loss, and preventing distal limb ischemia. This mandates careful preoperative planning and meticulous technique. Adjuvant treatments may be warranted, as in the case of preoperative embolization in patients with high-flow lesions.
authors.affiliation: From the Melbourne Orthopaedic Group and the Division of Hand Surgery, Department of Orthopaedic Surgery, Dandenong Hospital, Monash University, Melbourne, Victoria, Australia (Dr. Ek) and the Division of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, NY (Dr. Suh and Dr. Carlson).
authors.forename: Eugene T
authors.initials: ET
authors.lastname: Ek
authors.affiliation: From the Melbourne Orthopaedic Group and the Division of Hand Surgery, Department of Orthopaedic Surgery, Dandenong Hospital, Monash University, Melbourne, Victoria, Australia (Dr. Ek) and the Division of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, NY (Dr. Suh and Dr. Carlson).
authors.forename: Nina
authors.initials: N
authors.lastname: Suh
authors.affiliation: From the Melbourne Orthopaedic Group and the Division of Hand Surgery, Department of Orthopaedic Surgery, Dandenong Hospital, Monash University, Melbourne, Victoria, Australia (Dr. Ek) and the Division of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, NY (Dr. Suh and Dr. Carlson).
authors.forename: Michelle G
authors.initials: MG
authors.lastname: Carlson
mesh_terms: D003952:Diagnostic Imaging; D006225:Hand / Q000098:blood supply*; D006801:Humans; D054079:Vascular Malformations / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D014953:Wrist / Q000098:blood supply*