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Digital Periarterial Sympathectomy for Ischaemic Digital Pain and Ulcers

From the Division of Hand and Microsurgery, Department of Orthopaedics, University of Iowa Hospitals and Clinics, U.S.A

Correspondence: William F. Blair, M.D., Division of Hand and Microsurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, U.S.A.

Digital periarterial sympathectomy was performed on 11 digits in three patients with chronic digital ischaemia which was a manifestation of either Raynaud’s disease, C.R.E.S.T. syndrome or traumatic ulnar artery thrombosis. Before operation, all patients had pain in the affected fingers and five digits had ulcers, two of which were infected. Using the operating microscope, the adventitia was stripped circumferentially over the distal 2 cm. of the common digital arteries, the bifurcation and the proximal 1 cm. of the proper digital arteries distal to the bifurcation. The same procedure was repeated, at the wrist level, for the ulnar artery and/or the radial artery and its dorsal branch. Follow-up ranged from three to 16 months. After two weeks, all patients reported relief of pain and the ulcers were progressively healing. By three months, all ulcers had healed.

Journal of Hand Surgery (British and European Volume), Vol. 16, No. 4, 382-385 (1991)
DOI: 10.1016/0266-7681(91)90007-B


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