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Digital artery sympathectomy

A E Flatt

    The Journal of Hand Surgery
    |November 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

    A novel distal sympathectomy improved digital vascular insufficiency in frostbite and Raynaud

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    Area of Science:

    • Vascular Surgery
    • Microsurgery
    • Hand Surgery

    Background:

    • Digital vascular insufficiency presents significant challenges, often linked to conditions like frostbite, crush injuries, scleroderma, and Raynaud's disease.
    • Traditional sympathectomy approaches may not always provide optimal outcomes for distal digital circulation.
    • A refined surgical technique targeting the distal digital arteries could offer improved therapeutic benefits.

    Purpose of the Study:

    • To describe a newly devised very distal sympathectomy technique.
    • To evaluate the efficacy of this procedure in patients with digital vascular insufficiency.
    • To assess long-term outcomes, including symptom relief and physiological changes.

    Main Methods:

    • A palmar approach was used for the sympathectomy.

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  • The adventitia was removed from the proper digital arteries, distal to the junction with the distal perforating artery.
  • Eight patients (four men, four women) with various causes of digital vascular insufficiency underwent the procedure.

    • Main Results:

    • Three frostbite victims experienced ulcer healing, pain improvement, and a persistent 1.5–2.5°F skin temperature rise over 17 years.
    • Two patients with crushed fingers showed minor, non-impressive symptomatic improvement.
    • Three Raynaud's disease patients had varying results: two showed modest temperature increases (1–2°F) and significant pain relief, while one experienced normal nail regrowth and a 3°F temperature rise.

    Conclusions:

    • This very distal sympathectomy shows promising long-term results for digital vascular insufficiency, particularly in frostbite cases.
    • The procedure offers potential benefits for pain relief and temperature improvement in Raynaud's-type diseases, with notable nail regrowth in one case.
    • Further investigation is warranted to optimize outcomes for different etiologies of digital vascular compromise.