Cargando…

Ischemia of the fingers after carpal tunnel syndrome treatment

We present a case in which a depot triamcinolone acetonide (Kenacort) was unintentionally injected intra-arterially into the ulnar artery, resulting in microembolic capillary occlusion in the digits supplied by the artery. Ischemic changes and subungual petechial hemorrhages were seen in the ulnar t...

Descripción completa

Detalles Bibliográficos
Autores principales: Bosma, Niels H., de Jong, Tjeerd R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006639/
https://www.ncbi.nlm.nih.gov/pubmed/32083150
http://dx.doi.org/10.1080/23320885.2019.1711381
_version_ 1783495189516517376
author Bosma, Niels H.
de Jong, Tjeerd R.
author_facet Bosma, Niels H.
de Jong, Tjeerd R.
author_sort Bosma, Niels H.
collection PubMed
description We present a case in which a depot triamcinolone acetonide (Kenacort) was unintentionally injected intra-arterially into the ulnar artery, resulting in microembolic capillary occlusion in the digits supplied by the artery. Ischemic changes and subungual petechial hemorrhages were seen in the ulnar three digits. Angiography confirmed microembolic occlusion. The patient was treated with systemic vasodilative agents and a brachial plexus blockade. Tissue necrosis did not develop, however, the patient suffered lasting cold intolerance in the affected digits. Steroid suspension particles injected to treat CTS or other indications, can cause capillary occlusion and thereby microembolic tissue ischemia if injected intra-arterially. Choosing the right injection site and aspirating prior to injection is a simple though effective and indispensable measure to help prevent intra-arterial injection of steroid suspensions.
format Online
Article
Text
id pubmed-7006639
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Taylor & Francis
record_format MEDLINE/PubMed
spelling pubmed-70066392020-02-20 Ischemia of the fingers after carpal tunnel syndrome treatment Bosma, Niels H. de Jong, Tjeerd R. Case Reports Plast Surg Hand Surg Case Reports We present a case in which a depot triamcinolone acetonide (Kenacort) was unintentionally injected intra-arterially into the ulnar artery, resulting in microembolic capillary occlusion in the digits supplied by the artery. Ischemic changes and subungual petechial hemorrhages were seen in the ulnar three digits. Angiography confirmed microembolic occlusion. The patient was treated with systemic vasodilative agents and a brachial plexus blockade. Tissue necrosis did not develop, however, the patient suffered lasting cold intolerance in the affected digits. Steroid suspension particles injected to treat CTS or other indications, can cause capillary occlusion and thereby microembolic tissue ischemia if injected intra-arterially. Choosing the right injection site and aspirating prior to injection is a simple though effective and indispensable measure to help prevent intra-arterial injection of steroid suspensions. Taylor & Francis 2020-01-20 /pmc/articles/PMC7006639/ /pubmed/32083150 http://dx.doi.org/10.1080/23320885.2019.1711381 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Bosma, Niels H.
de Jong, Tjeerd R.
Ischemia of the fingers after carpal tunnel syndrome treatment
title Ischemia of the fingers after carpal tunnel syndrome treatment
title_full Ischemia of the fingers after carpal tunnel syndrome treatment
title_fullStr Ischemia of the fingers after carpal tunnel syndrome treatment
title_full_unstemmed Ischemia of the fingers after carpal tunnel syndrome treatment
title_short Ischemia of the fingers after carpal tunnel syndrome treatment
title_sort ischemia of the fingers after carpal tunnel syndrome treatment
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006639/
https://www.ncbi.nlm.nih.gov/pubmed/32083150
http://dx.doi.org/10.1080/23320885.2019.1711381
work_keys_str_mv AT bosmanielsh ischemiaofthefingersaftercarpaltunnelsyndrometreatment
AT dejongtjeerdr ischemiaofthefingersaftercarpaltunnelsyndrometreatment