Temporary arterial stenting in a full-house spaghetti wrist injury in a remote rural setting: benefit for hand perfusion or risk of increased morbidity?

Abstract

We report a case of temporary arterial plastic tube stenting of the ulnar and radial artery in a complete spaghetti wrist injury in a remote rural setting. Exploration in a specialist centre 18 h postinjury revealed that the tubes were clotted off with adjacent thrombi but hand perfusion was maintained. Intimal damage required vein grafting of both arteries 24 h postinjury. Hand perfusion was not compromised at follow-up. This case highlights that arterial hand perfusion can be maintained without the ulnar and radial artery. Arterial manipulation and tube insertion outside a specialist centre bears the risk of increased morbidity and potential microembolism and must therefore not be attempted.

• Authors: Stefan Bauer, James Savundra
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2013 (Mar 15 2013) ISSN: 1757-790X [Electronic] England
• PMID: 23505277 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Embolism (etiology)
• Hospitals, Rural
• Humans
• Male
• Radial Artery (injuries, surgery)
• Regional Blood Flow
• Risk Factors
• Stents (adverse effects)
• Time Factors
• Ulnar Artery (injuries, surgery)
• Wrist Injuries (surgery)