Progressive fingertip necrosis after nail avulsion injury in a patient with ulnar artery hypoplasia: A case report

Slowly progressive hand ischemia is mostly associated with medical illness such as vasculitis, and in patients with smoking history, Buerger disease is often considered first. However, despite the very low incidence of vascular anatomical anomalies, they can lead to hand ischemia. And if there is no...

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Bibliographic Details
Published in:Medicine (Baltimore) 2017-04, Vol.96 (14), p.e6324-e6324
Main Authors: Jeong, Yeon Jin, Park, Seong Hyuk, Lee, Jun Yong
Format: Article
Language:English
Subjects:
Adult
Clinical Case Report
Finger Injuries - complications
Finger Injuries - pathology
Finger Injuries - surgery
Fingers - blood supply
Fingers - pathology
Humans
Ischemia - etiology
Ischemia - pathology
Male
Necrosis
Ulnar Artery - abnormalities
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Summary:Slowly progressive hand ischemia is mostly associated with medical illness such as vasculitis, and in patients with smoking history, Buerger disease is often considered first. However, despite the very low incidence of vascular anatomical anomalies, they can lead to hand ischemia. And if there is no consideration for them, proper treatment cannot be selected. A 42-year-old male smoker presented with a slowly progressing 5th fingertip necrosis following blunt trauma. Angiography revealed congenital hypoplasia of ulnar artery, and excluded Buerger disease or hypothenar hammer syndrome. We reconstructed the necrotic fingertip using a 2nd toe pulp free flap to reflect the patient's need. In this case report, the authors emphasize that the possibility of anatomical anomaly should be considered as a cause of the ischemia. Vascular imaging should be undertaken to investigate the cause of ischemia of the hand.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000006324