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The Journal of Bone and Joint Surgery 79:441-3 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Digital Ischemia Associated with a Thrombosed Aneurysm of the Dorsal Interosseous Artery. A Case Report*

DERMOT A. O'FARRELL, M.CH., F.R.C.S.I.{dagger}, DAVID P. CANNON, M.D.{dagger} and JAMES A. NUNLEY, M.D.{dagger}, DURHAM, NORTH CAROLINA

Investigation performed at the Division of Orthopaedics, Department of Surgery, Duke University Medical Center, Durham


   Introduction
 
True aneurysms in the upper extremity are unusual, particularly in the absence of trauma3,9. We report the treatment of digital ischemia caused by thrombosis of an aneurysmal dorsal interosseous artery. Our report is noteworthy in that the patient also had bilateral congenital absence of the radial artery, a rare and embryologically primitive variation of human anatomy8.


   Case Report
 
A fifty-five-year-old healthy woman who worked at a restaurant was referred to us because of a twenty-four-hour history of pain, numbness, and bluish discoloration of the left index finger. Clinical examination revealed an absent radial pulse and a positive Allen test7, denoting inadequate inflow through the radial artery. For the Allen test, the patient performed repeated, forceful flexion and extension of the digit while the examiner applied pressure to the volar radial and ulnar arteries at the wrist with his thumbs and pressed on the dorsal aspect of the wrist with . . . [Full Text of this Article]


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