Upper extremity arterial injury in athletes

Area of Science:

• Sports Medicine
• Vascular Surgery
• Diagnostic Imaging

Background:

• Athletes can experience arm and hand complaints due to vascular compression.
• Thoracic outlet compression and hand ischemia are significant concerns in athletic populations.

Purpose of the Study:

• To evaluate arm and hand complaints in athletes.
• To identify the role of thoracic outlet compression and arterial issues.
• To assess diagnostic and treatment strategies for these conditions.

Main Methods:

• Noninvasive testing including Doppler ultrasonography, duplex scanning (positional testing, finger systolic pressure), and cold immersion.
• Arteriography to confirm arterial compression and thrombosis.
• Surgical decompression (anterior scalenectomy, pectoralis minor division, cervical rib resection) and conservative management (Dextran-heparin infusion).

Main Results:

• Eleven of 23 athletes had thoracic outlet compression; eight presented with severe arm fatigue, three with finger ischemia.
• Hand ischemia was predominant in 12 athletes.
• Arteriography confirmed various arterial compressions and two cases of subclavian aneurysm; thrombosis of the ulnar artery and palmar arch occlusion were also noted.
• Surgical decompression and conservative treatments led to all athletes resuming their careers without recurrence.

Conclusions:

• Hand ischemia in athletes can be effectively diagnosed noninvasively.
• Surgical decompression of the thoracic outlet and branch arteries, alongside conservative management, can successfully treat vascular complications in athletes.
• Early diagnosis and intervention prevent severe complications like arterial thrombosis from repetitive trauma.