Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the Wrist

A 75-year-old woman presented with progressing pain, cyanosis, and hypaesthesia in her left hand after an intra-articular injection with diazepam into the wrist for osteoarthritis-related pain. Due to an iatrogenic intra-arterial injection, malperfusion of the ulnar digits developed. Angiography rev...

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Bibliographic Details
Main Authors: Niklas Iblher, Gerd Bjoern Stark, Vincenzo Penna
Format: Article
Language:English
Published: Hindawi Limited 2011-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2011/347523
Description
Summary:A 75-year-old woman presented with progressing pain, cyanosis, and hypaesthesia in her left hand after an intra-articular injection with diazepam into the wrist for osteoarthritis-related pain. Due to an iatrogenic intra-arterial injection, malperfusion of the ulnar digits developed. Angiography revealed blockage of perfusion of the 4th and 5th digits. Despite intra-arterial lysis, heparinisation, and vasodilatation, perfusion could not be reinstalled. Necrosis of the distal phalanges of the 4th and 5th digits developed, which had to be treated with amputation. The pathomechanism of tissue damage and the treatment options after intra-arterial injections are reviewed and discussed.
ISSN:2090-6900
2090-6919