Traumatic injury of radial and ulnar artery with perfusion of the hand through the median artery: a case report

Case description: A young male patient with a complete section of the ulnar and radial arteries preserved the perfusion of the hand through an anatomical variant, the median artery, identified by angiotomography. Clinical Findings: A wound in the distal third of the left forearm with present pulses and adequate hand coloration. An angiotomography of the upper left limb showed a median artery originating as a continuation of the anterior interosseous artery and ending in the palm of the hand with an incomplete superficial palmar arch. Treatment and Outcomes: Ligation of both radial and ulnar arteries was performed. It was not possible to follow up with the patient. Clinical Relevance: Forming the superficial and deep palmar arches, the irrigation of the hand comes from the ulnar and radial arteries, which can compromise the viability of the limb when injured. The median artery is present in 0.6-21.1% of the population, originates from the anterior interosseous artery (branch of the ulnar), accompanies the median nerve in its path and ends in the palm joining the superficial palmar arch. Diagnostic imaging is a key tool for assessing arterial circulation and characterizing upper limb vascular lesions. Knowledge of the anatomical variations of the arterial supply of the hand, including variability of the superficial palmar arch, is crucial for the safety and success of hand surgeries.

Forearm Compartment Syndrome Concomitant with Pseudoaneurysm of the Anterior Interosseous Artery after Minor Penetrating Injury

A 16-year-old man sustained a minor penetrating injury to his forearm, resulting in pseudoaneurysm formation that caused acute compartment syndrome with muscle contracture. Surgical treatment, including fasciotomy, evacuation of the hematoma and aneurysmectomy, followed by intensive hand therapy provided a successful outcome. Traumatic pseudoaneurysm after penetrating injury is a rare cause of acute forearm compartment syndrome. Although minor penetrating injuries tend to be underestimated, this type of injury can cause subsequent serious pathological conditions.

A LARGE NEURINOMA ORIGINATING FROM THE ANTERIOR INTEROSSEOUS NERVE

We report an interesting case of a neurinoma originating from the anterior interosseous nerve. Magnetic resonance (MR) images showed an egg-shaped, well-circumscribed mass on the volar side of the forearm. On the enhanced three-dimensional computer tomography (3D-CT), it was clearly demonstrated that the tumour had arterial feeding from the anterior interosseous artery. The enhanced 3D-CT angiography was useful in the pre-operative diagnosis and surgical planning of peripheral neurinomas.