Background. Vascular anomalies in the hand do not occur frequently. Their
presence in the metacarpal region can cause different functional disorders.
The extent of such disorders directly depends on the localization and size of
vascular anomalies, duration and the nature of the anomaly growth as well as
on eventual secondary complications such as ulceration or bleeding. The aim
of this case report was to show the specifics in the clinical picture,
pathogenesis and evolution of such anomalies, applied diagnostic procedures
(radiography, ultrasound, magnetic resonance, electromyography) and surgical
treatment as well as postoperative functional results. Case report. In the
Clinic for Plastic Surgery and Burns, Military Medical Academy Belgrade, two
patients were treated surgically for vascular anomalies of the middle palmar
region of the hand. The first patient, a 36-year-old male, a former active
sportsman (professional handball player) was treated for acute increase in
the vascular anomaly of hand in the metacarpal region and proximal phalange
of III and IV fingers of his right hand. The anomaly was detected 6 months
prior to his hospitalization while two weeks before the hospitalization there
was a sudden growth and increase in the change. The second case, a
15-year-old male patient actively pursuing a career in professional
basketball was treated for a tumor localized in the metacarpal zone of his
left hand. According to the information provided by his parents, the anomaly
had been present since his birth. Initially, the anomaly manifested itself as
a discoloration of the skin with a marked capillary drawing, gradually
increasing throughout the last five years to the present dimension. The
growth of the malformation was noticed to coincide in both patients with more
active pursuit of their professional sports career. Conclusion. The clinical
picture of hand vascular anomalies is dominated by the symptoms of
compression of neurovascular structures (paresthesia, intense hand pain,
swollen fingers). If it is a chronic progressive process, signs of ischemic
intrinsic muscle fibrosis with corresponding functional deficit, as well as
tissue defect (usura) of bone and joint structures represent the basic
pathological findings. Acute increase is accompanied by compartment syndrome
symptoms and ischemic fibrosis of intrinsic hand musculature and development
of irreversible dysfunction of the hand. In the presented cases rapid
response implies accurate diagnostic methods followed by surgical extirpation
in order to treat compartment syndrome.
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