The Journal of Bone and Joint Surgery, Vol 66, Issue 5 764-769, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
The orthopaedic implications of purpura fulminans
ST Canale and ST Ikard
The syndrome of purpura fulminans has frequently been reported in the
surgical and pediatric literature, but rarely in the orthopaedic
literature. The mortality rate has decreased dramatically from early
reports of approximately 90 per cent to more recent reports of 18 per cent.
Amputation of a portion of the involved extremities, however, is usually
required in the patients who survive. Over a twelve-month period, we
treated four patients who had purpura fulminans, with resultant vasospasm
and secondary ischemic gangrene. In three of the patients the syndrome
developed following a one to two-day febrile illness, and in one, following
varicella. All four patients survived, but two required a bilateral
lower-limb amputation; one, a Syme amputation and a partial hand
amputation; and one, an amputation of the fore part of the foot.
Autoamputation of multiple fingertips and toes occurred in two of the four
patients.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
