Document Detail


Occlusive arterial disease of the hand due to repetitive blunt trauma: a review with illustrative cases.
MedLine Citation:
PMID:  8463009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: to increase clinical awareness of the role of repetitive blunt trauma, often occupational, in the development of occlusive arterial disease of the hand. STUDY DESIGN: illustrative cases are presented to emphasize the varied etiology and clinical features of occlusive arterial disease of the hand resulting from repetitive blunt trauma and an historical review of the literature is presented. RESULTS: Occlusive arterial disease of the hand due to repetitive blunt trauma is a common but often preventable disorder. The superficial location of many of the arteries of the hands and digits plus their close proximity to the bones of the hand makes them uniquely susceptible to injury from repetitive blunt trauma. An ever increasing number of occupations and leisure activities have been causally related to occlusive arterial disease of the hand. The diagnosis of occupational occlusive arterial disease due to blunt trauma is suggested by eliciting a history of repetitive blunt trauma to the hand in a patient with symptoms and/or signs of digital ischemia. The dominant hand is most commonly involved, but the non-dominant hand or both hands are affected in certain occupations. Possible predisposing or aggravating factors include tobacco use and working in a cold environment. The diagnosis of occlusive arterial disease confined to the hand or digits is confirmed by non-invasive studies in the vascular laboratory and demonstrated by arteriography. Conservative measures and protection of the hand from further trauma is sufficient for most patients, with surgical therapy being reserved for patients refractory to medical therapy or those with more severe ischemia. CONCLUSION: occlusive arterial disease of the hand may be more common than formerly thought and is often preventable by the proper use of hand tools or instruments and hand protection. This is another type of occlusive arterial disease in which tobacco may be a predisposing or aggravating factor.
Authors:
P C Spittell; J A Spittell
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  International journal of cardiology     Volume:  38     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-05-06     Completed Date:  1993-05-06     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  281-92     Citation Subset:  IM    
Affiliation:
Division of Internal Medicine and Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arterial Occlusive Diseases / epidemiology,  etiology*
Cumulative Trauma Disorders / complications*,  epidemiology
Hand / blood supply*
Hand Injuries / complications*,  epidemiology
Humans
Male
Middle Aged
Occupational Diseases / epidemiology*
Smoking / adverse effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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