Duke Orthopaedics
presents
Wheeless' Textbook of Orthopaedics

Vascular Problems of the Wrist and Hand


- See:
   - Burns of the Hand
   - Thrombolytic Therapy

- Ischemia of the Hand:
    - History:
         - infection, cold intolerance, pain, tenderness, of mass, cyanosis
         - Treatment of digital ischemia with liposomal bupivacaine.

- Diff dx:
         - Aneurysms of the Upper Extremity
         - AV malformations
         - Compression in the neck (see throacic outlet syndrome)
         - DVT: Paget–Schroetter syndrome
         - Emboli to Upper Extremity Vessels
         - Erythromelalgia
         - Glomus Tumor
         - Primary vasospastic condition
         - Pyogenic granuloma (cure by cautery)
         - Trauma
         - Hemangioma
         - Raynaud's Phenomenon and Disease
         - Venous Malformations
         - Effort Thrombosis of Axillary Vein
         - Thromboangiitis obliterans
                - small-vessel involvement in both the arms and the legs;
         - Scleroderma
         - CREST syndrome (calcinosis cutis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia)
         - Repetitive trauma (vibratory-tool use or hypothenar hammer syndrome)
         - Hypothenar Hand Syndrome
         - Waldenström's macroglobulinemia 

- Diagnostic Studies:
         - EKG
         - CBC, ANA, Sed Rate, RF, HbS,
         - Cold Stress Test
         - ABI
         - Plethysmography;
         - Cardiac Echo (to rule out cardiac vegitations)



Distinguishing Soft-Tissue Hemangiomas From Vascular Malformations Using Technetium-Labeled Red Blood Cell Scintigraphy.

Reversal of digital vasospasm by glyceryl trinitrate patch.

Vascular abnormalities of the extremities: clinical findings and management.

Limited Microsurgical Arteriolysis for Complications of Digital Vasospasm.

Hemangiomas, vascular malformations, and lymphovenous malformations: classification and methods of treatment.

Major vascular malformations of the upper extremity: long-term observation.

The microcirculatory effects of peripheral sympathectomy

Arterial reconstruction in the ischemic hand and wrist: effects on micro-vascular physiology and health-related quality of life.

Anatomic and physiologic evaluation of upper extremity ischemia.

Acquired localized subcutaneous cavernous vascular malformations of the hand.

Arterial and Venous Injuries in Athletes.  Findings and Their Effect on Diagnosis and Treatment

Images in Clinical Medicine Digital Gangrene

Images in clinical medicine. Differential clubbing and cyanosis.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, June 18, 2014 1:23 pm

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