Pulse oximetry for preoperative vascular assessment in a thumb near-amputation

Pulse oximetry, or photoplethysmography, is widely available in emergency departments and intuitively seems well suited to the evaluation of vascular compromise in digital trauma. In a review of the medical literature, no cases were found in which pulse oximetry was used in preoperative assessment of a traumatized digit. We report the case of a patient with a near-amputation of his thumb in whom pulse oximetry proved to be a valuable tool in his evaluation and treatment because it was a rapid, noninvasive, sensitive means of assessment of digital vascular viability. Evaluation and management of this patient is discussed, and the pertinent literature concerning the use of pulse oximetry and vascular injuries of the hand is reviewed.