Microsurgical revascularisation of the hand in scleroderma

Neil Ford Jones, Stephen C Raynor, Thomas A. Medsger

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Raynaud's phenomenon is a prominent manifestation of systemic sclerosis (scleroderma) affecting the hand. The resulting digital ischaemia may progress to digital tip ulceration or gangrene. Four patients with scleroderma, presenting with severe unremitting unilateral pain in the hand, were evaluated by arteriography and plethysmography. In addition to the usual changes of narrowing and occlusion of the digital arteries themselves, arteriography revealed more proximal occlusion of the radial and ulnar arteries at the wrist and the superficial palmar arch. Plethysmography confirmed virtual absence of pulsatile digital blood flow. Two patients underwent microsurgical reconstruction of the radial and ulnar arterial inflow into the hand and the superficial palmar arch using reversed interposition vein grafts, with immediate subjective resolution of their severe pain and rapid healing of the digital ulcers. Both remain pain free 1 year post-operatively, and pulse-volume recordings have confirmed objectively the restoration of pulsatile blood flow to the fingers.

Original languageEnglish (US)
Pages (from-to)264-269
Number of pages6
JournalBritish Journal of Plastic Surgery
Volume40
Issue number3
DOIs
StatePublished - Jan 1 1987

Fingerprint

Plethysmography
Hand
Systemic Scleroderma
Angiography
Ulnar Artery
Pain
Pulsatile Flow
Raynaud Disease
Radial Artery
Gangrene
Wrist
Fingers
Ulcer
Pulse
Veins
Ischemia
Arteries
Transplants
Pain-Free

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Microsurgical revascularisation of the hand in scleroderma. / Jones, Neil Ford; Raynor, Stephen C; Medsger, Thomas A.

In: British Journal of Plastic Surgery, Vol. 40, No. 3, 01.01.1987, p. 264-269.

Research output: Contribution to journalArticle

Jones, Neil Ford ; Raynor, Stephen C ; Medsger, Thomas A. / Microsurgical revascularisation of the hand in scleroderma. In: British Journal of Plastic Surgery. 1987 ; Vol. 40, No. 3. pp. 264-269.
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