Late salvage of the ischemic finger after crush injury using flow-through flaps: case report

J Hand Surg Am. 2009 Mar;34(3):453-7. doi: 10.1016/j.jhsa.2008.11.020.

Abstract

The progressive evolution and late salvage of a posttraumatic digit with poor vascularization has not been discussed in the literature. We report the cases of 3 patients whose fingers were rescued at referral 5 to 16 days after the traumatic event by restoring the arterial inflow by means of flow-through free flaps. All 3 fingers were compromised vascularly with patchy necrosis and absence of Doppler signal distal to the injury. All were salvaged. In our experience, in the setting of a posttraumatic digit with poor vascularization, it is possible to reverse impending necrosis by late revascularization. Frank infection or mummification is considered an irreversible state and a contraindication to salvage.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Finger Injuries / complications
  • Finger Injuries / surgery*
  • Fingers / blood supply*
  • Fingers / pathology
  • Fingers / surgery
  • Humans
  • Ischemia / etiology
  • Ischemia / surgery*
  • Male
  • Necrosis
  • Salvage Therapy*
  • Surgical Flaps / blood supply*