Digital periarterial sympathectomy in the management of post-traumatic Raynaud syndrome.
OBJECTIVE
Among Basque handball players, the repeated impact of a ball on the palms of their hands hundreds of thousands of times throughout their sporting careers produces Raynaud syndrome. Treating this patient group is complex. Our objective was to assess the efficacy of digital periarterial sympathectomy in this patient group.


METHODS
The study included all of the federated amateur and professional Basque handball patients who presented with Raynaud syndrome assessed in the vascular surgery service between January 2005 and December 2012. The postoperative assessment included a physical examination, basal photoplethysmography and photoplethysmography after heat hyperemia, and arteriography or magnetic resonance angiography.


RESULTS
All 182 digital periarterial sympathectomies in the 114 fingers of 60 patients were in Porter functional class III or IV. All patients were discharged within the first 48 hours. Follow-up results, with a mean of 2 years ± 5 months, were 100%. All patients presented immediate pain remission, recovery of comfort, normal nail growth, rapid healing of all ulcers, distal anhidrosis, and return to active sport participation. The results remain steady in 58 patients (93.5%). Mean time until return to sports activity was 9.95 ± 1.61 weeks.


CONCLUSIONS
Digital periarterial sympathectomy is a simple, relatively nonaggressive technique without adverse side effects and with excellent medium-term results. In patients with Raynaud syndrome refractory to medical treatment and with threat to the viability of one or several fingers, digital periarterial sympathectomy can be the first treatment option, especially in cases of arteritis associated with very severe spasms.
Cátedra de Ingeniería Biomédica y Tecnologías Sanitarias, Universidad Católica San Antonio (UCAM), Murcia, Spain; Centro de Ingeniería Biomédica y Tecnologías Sanitarias, Madrid, Spain; Department of Vascular Surgery, Policlínica Gipuzkoa, San Sebastián, Spain.
Ander
A
Letamendia
Cátedra de Fisiología del Deporte, Universidad Católica San Antonio (UCAM), Murcia, Spain.
Javier
J
López-Román
Department of Cardiovascular Surgery, Hospital Universitario de La Princesa, Madrid, Spain. Electronic address: jbustamantemunguira@gmail.com.
Juan
J
Bustamante-Munguira
Cátedra de Ingeniería Biomédica y Tecnologías Sanitarias, Universidad Católica San Antonio (UCAM), Murcia, Spain; Centro de Ingeniería Biomédica y Tecnologías Sanitarias, Madrid, Spain; Department of Cardiac Surgery, Hospital Nisa Pardo Aravaca, Madrid, Spain.
Jesús
J
Herreros
D000328:Adult; D001158:Arteries / Q000294:innervation*; D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000098:blood supply*; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D017156:Photoplethysmography; D011928:Raynaud Disease / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012074:Remission Induction; D012189:Retrospective Studies; D013030:Spain; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult