This paper is only available as a PDF. To read, Please Download here.
Raynaud's phenomenon is a prominent manifestation of systemic sclerosis (scleroderma) affecting the hand. The resulting digital ischaemia may progress to digital tip ulceration or gangrene. Four patients with scleroderma, presenting with severe unremitting unilateral pain in the hand, were evaluated by arteriography and plethysmography. In addition to the usual changes of narrowing and occlusion of the digital arteries themselves, arteriography revealed more proximal occlusion of the radial and ulnar arteries at the wrist and the superficial palmar arch. Plethysmography confirmed virtual absence of pulsatile digital blood flow. Two patients underwent microsurgical reconstruction of the radial and ulnar arterial inflow into the hand and the superficial palmar arch using reversed interposition vein grafts, with immediate subjective resolution of their severe pain and rapid healing of the digital ulcers. Both remain pain free 1 year post-operatively, and pulse-volume recordings have confirmed objectively the restoration of pulsatile blood flow to the fingers.
- The place of upper dorsal sympathectomy in the treatment of primary Raynaud's disease.British Journal of Surgery. 1965; 52: 426
- Digital arteries in patients with scleroderma.Archives of Internal Medicine. 1972; 130: 708
- Digital artery sympathectomy.Journal of Hand Surgery. 1980; 5: 550
- Reciprocal skin grafts in systemic sclerosis (scleroderma).Arthritis and Rheumatism. 1971; 14: 571
- Blood flow and blood pressure in fingers in generalized scleroderma.International Journal of Dermatology. 1982; 21: 404
- Arthritis and Allied Conditions. Lea and Febinger, Philadelphia1985 Systemic Sclerosis (Scleroderma). 10th edition.
- The clinical significance of Raynaud's syndrome.Surgery. 1976; 80: 756
- Treatment of Raynaud's phenomenon with ketanserin in patients with connective tissue disorders.British Medical Journal. 1984; 289: 577
- Morphological changes in the digital arteries of patients with progressive systemic sclerosis (scleroderma) and Raynaud's phenomenon.Medicine. 1980; 59: 393
- Intra-arterially administered reserpine and saline in scleroderma.Archives of Internal Medicine. 1974; 134: 515
- Treatment of finger ischemia with Bier block reserpine.Surgery, Gynecology and Obstetrics. 1982; 154: 39
- Evaluation and treatment of chronic digital ischemia.Annals of Surgery. 1981; 193: 693
- Nifedipine as a therapeutic modality for Raynaud's phenomenon.Arthritis and Rheumatism. 1983; 26: 1177
© 1987 The Trustees of British Association of Plastic Surgeons. All rights reserved. Published by Elsevier Inc.