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

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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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
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spelling doaj-3a9c94d4db5946af965a15c2d7f9da882020-11-24T23:54:16ZengHindawi LimitedCase Reports in Surgery2090-69002090-69192011-01-01201110.1155/2011/347523347523Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the WristNiklas Iblher0Gerd Bjoern Stark1Vincenzo Penna2Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Plastic and Hand Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Plastic and Hand Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, 79106 Freiburg, GermanyA 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.http://dx.doi.org/10.1155/2011/347523
collection DOAJ
language English
format Article
sources DOAJ
author Niklas Iblher
Gerd Bjoern Stark
Vincenzo Penna
spellingShingle Niklas Iblher
Gerd Bjoern Stark
Vincenzo Penna
Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the Wrist
Case Reports in Surgery
author_facet Niklas Iblher
Gerd Bjoern Stark
Vincenzo Penna
author_sort Niklas Iblher
title Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the Wrist
title_short Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the Wrist
title_full Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the Wrist
title_fullStr Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the Wrist
title_full_unstemmed Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the Wrist
title_sort necrosis of the 4th and 5th digits after intra-articular injection of diazepam into the wrist
publisher Hindawi Limited
series Case Reports in Surgery
issn 2090-6900
2090-6919
publishDate 2011-01-01
description 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.
url http://dx.doi.org/10.1155/2011/347523
work_keys_str_mv AT niklasiblher necrosisofthe4thand5thdigitsafterintraarticularinjectionofdiazepamintothewrist
AT gerdbjoernstark necrosisofthe4thand5thdigitsafterintraarticularinjectionofdiazepamintothewrist
AT vincenzopenna necrosisofthe4thand5thdigitsafterintraarticularinjectionofdiazepamintothewrist
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