Surgical Treatment of Vascular Malformations in the Hand
As the hand is an organ of many different structures, located in a small space, with a high functional value, congenital vascular malformations (CVM) may easily involve many tissues, presenting complex clinical pictures that are difficult to treat. Surgical treatment is possible but general principles of hand surgery should be followed. Skin incisions should be carefully planned to save hand function. Bleeding is reduced by the use of a tourniquet. Magnification with a microscope during surgery is crucial for a precise dissection and recognition of neurovascular pedicles. In case of nerve involvement, external neurolysis is the first choice, as interfascicular treatment is a risky procedure. Total or partial resection of infiltrated muscles should be carefully performed, according to their function. Intraosseous arteriovenous (AV) malformations are best treated by direct occlusion through alcohol or glue injection, avoiding surgery.
KeywordsArteriovenous Malformation Vascular Malformation Venous Malformation Hand Surgery Glue Injection
Unable to display preview. Download preview PDF.
- 1.Levame J-H, Durafourg MP (1987) Reeducation des traumatises de la main. Maloine, ParisGoogle Scholar
- 3.Belov S (1989) Classification, terminology and nosology of congenital vascular defects. In: Belov S, Loose DA, Weber J (eds) Vascular malformations. Einhorn-Presse Verlag, Reinbek, pp 25–30Google Scholar
- 5.Mattassi R (1993) Diagnosis and treatment of venous malformations of the lower limbs. In: Mattassi R (ed) Proceedings of the international conference on vascular surgery. Beijing, China, October 21–24, International Academic Publishers, p 397Google Scholar
- 8.Di Giuseppe P (2003) Principi di trattamento delle malformazioni vascolari della mano. In: Mattassi R, Belov S, Loose DA, Vaghi M (eds) Malformazioni vascolari ed emangiomi. Springer-Verlag, Milano, pp 160–165Google Scholar
- 11.Di Giuseppe P (2006) Le angiodisplasie venose della mano ed il coinvolgimento dei tessuti. Riv Chir Mano 43:102–105Google Scholar