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Multiple digital gangrene after a radial artery penetrating injury: a case report.

Lin TL, Huang F, Chen CC, Shih HS, Hsieh CH

Department of Plastic and Reconstructuve Surgery, Chang-Gung Memorial Hospital-Kaohsiung Medical Center, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan.

We describe the case of a young female patient who sustained a radial artery penetration injury from broken glass after falling and was managed only by external compression without arterial repair. Although the patient did not have any reported predisposing factors and the radial artery was normal as well as patent in the angiographic examination, she developed progressive multiple digital ischemia and required subsequent amputation of the gangrenous fingers. The possible mechanism might be an occlusion of the digital arteries originating from the injured radial artery by dispersion of thrombembolic particles distally during the injury as there was sparing of involvement of the ring finger, which wore a ring that restricted the thromboembolic particles from passing distally during the accident. This case revealed that particular attention should be paid to those patients with a radial artery penetration injury to facilitate early detection and implementation of therapy for possible finger ischemia and subsequent gangrene.

Published 8 May 2007 in Ann Vasc Surg, 21(3): 384-7.
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