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Young patient, miner, diverse symptoms of bad vascularization in his hand like the bluish coloration of his fingers. The diagnosis points to an ischemic upper limb due to poor irrigation, caused by the progressive closure of the vessels due to repetitive microtraumas. ischemic hand
The problem
The continuous use of pneumatic machines that produce vibration can lead to ischemia. This is the case of analysis, in which there exists a vascular occlusion due to damage to the walls of the most superficial vessels, including the ulnar artery, with associated thrombosis. In essence, the recurrent percussion on the hand and wrist by the tools used in his work is at the origin of the pathology of the patient.
The goals
The clinical goals of Dr. Piñal and his surgical unit are to restore the irrigation of the affected area, recovering the ulnar artery by means of microsurgery through a bypass.
The plan
The Spanish surgeon designs a surgical approach that includes the use of a sort of ‘dowel pins’ that allow the vessels to be threaded. Thus, not only the effectiveness of the procedure is improved, but the application of a less invasive technique limits the aesthetic impact of the surgery.
The bypass or arterial anastomosis on the thrombosed ulnar, taking an artery segment of the patient’s belly, returns the blood supply to the damaged area. In turn, the intervention facilitates the ulnar artery to move to a deeper position, using a ‘pin’ and connecting it to the superficial palmar arch.
The recovery of irrigation, however, is not fully achieved in the little finger, which is applied a second arterial graft, this is a new bypass, which solves the situation.
The results
The first composition of pictures allows to observe the use of a ‘dowel pin’ that ‘threads’, that is, it facilitates the canalization and connection by microsurgery of the second arterial graft, minimizing the invasiveness of the process. In the second block, functional and aesthetic recovery of the affected hand after the procedure and the corresponding vascular restoration.Once the surgical process is completed, the patient’s hand again enjoys adequate irrigation, preserving its function and with a minimal aesthetic impact.