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Buerger's disease--a review of 105 patients
Insights
Buerger's disease predominantly affects toes and fingers, with a high rate of amputation. Reconstructive surgery for Buerger's disease is rarely successful, often leading to amputation.
Area of Science:
- Vascular Surgery
- Medical Case Review
Background:
- Buerger's disease, also known as thromboangiitis obliterans, is a rare inflammatory condition affecting blood vessels, primarily in the extremities.
- It disproportionately impacts young male smokers, leading to ischemia and potential limb loss.
Purpose of the Study:
- To review the clinical presentation, treatment, and outcomes of Buerger's disease cases in Hong Kong.
- To analyze the patterns of digit involvement and the efficacy of surgical interventions.
Main Methods:
- Retrospective review of 105 Buerger's disease cases.
- Analysis of patient demographics, affected digits, surgical procedures (amputation, sympathectomy, arterial reconstruction), and outcomes.
Main Results:
- Predominant involvement of the big, second, and little toes; index and middle fingers.
- No significant left-right side selectivity in affected extremities.
- Majority of patients underwent amputation or sympathectomy; 22.6% required major lower limb amputation.
- Reconstructive arterial surgery had a high early failure rate (3 out of 4 cases).
Conclusions:
- Buerger's disease in Hong Kong shows characteristic digit involvement patterns.
- Surgical management frequently involves amputation due to limited success with reconstructive arterial surgery.
- This highlights the severe nature of the disease and challenges in limb salvage.
Abstract:
One hundred and five cases (101 males and four females) of Buerger's disease occurring in Hong Kong have been reviewed. In the foot the digits affected were predominantly the big, second and little toes, whereas in the hand the index and middle fingers were most commonly involved. There was no selective involvement of the left or right side in the upper or lower extremities. The majority of patients were operated on and had amputation, sympathectomy, or both procedures performed. Major lower limb amputation was carried out in 22.6% of patients with lower limb involvement. Reconstructive arterial surgery was possible in only four patients, and early failure of grafts in three patients resulted in major amputation.