| Popis: |
Over 1,400,000 cases of hand trauma are identified each year in France, with a large proportion with open wounds, accounting for significant activity in orthopedic surgery emergency units. It is customary to focus on nerve or tendon injuries as a priority. However, even partial vascular lesions may be complicated by a false aneurysm. We report the case of a false aneurysm of the palmar branch of the radial artery in 25-year-old man, 6 months after a non-treated puncture wound of the thenar eminence. Surgery was undertaken because of increased volume and discomfort on gripping. The surgical procedure consisted of resection and arterial ligature, after a positive preoperative Allen test. Hand aneurysms require an individualized therapeutic procedure. Origins may be diverse; the palmar digital location requires complex treatment. Compensation via a collateral arterial network is required for the vascular steal following ligation and resection. Careful exploration is needed to ensure appropriate compensation. Otherwise, a revascularization procedure must be considered. Some authors propose new less invasive treatments as an alternative to surgery. Even though surgery is relatively simple, the best means of prevention still remains a systematic exploration of vascular elements in case of a hand wound. |
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