A laceration is a tear or ragged opening in the skin usually caused by an injury or trauma. A laceration may be either a partial laceration or a complete laceration. Since the nerves of the hands are located very close to the arteries, a laceration may damage them as well, causing numbness in your fingers.
Causes
Arterial lacerations may be caused by blunt trauma such as a sudden blow or a fall or by sharp objects such as a knife or broken glass.
Symptoms
The symptoms of an arterial laceration include pain, discolouration and swelling of the limb distal to the injury. There may be numbness due to associated or secondary nerve dysfunction. Active and passive movements will be present and maybe painful due to associated compartment syndrome.
Diagnosis
The diagnosis of an arterial laceration is made on the basis of your history and physical examination. An X-ray may be taken to rule out any fractures or foreign bodies. An arterial doppler ultrasound may help to confirm the diagnosis of a lacerated artery and localize the proximal end of the retracted artery. If the arteries are lacerated, Dr Bala may order an CT angiography which is a contrast study to determine the level and extent of damage to the artery. Often a vascular or plastic surgeon is consulted in concurrence to deal with such injuries.
Treatment
Arterial lacerations may require nerve repair using microvascular techniques if there is no artery substance loss. If there is artery substance loss a reversed vein graft maybe required which may be harvested from the patients’ own body.
Dr Bala uses special magnification loupes during surgery to visualize and protect these important structures to minimize complications. He has been trained in arterial repair with techniques his mentors have acquired from the Kleinert Institute, Kentucky USA. Aggressive hand physiotherapy is usually prescribed to regain range of motion, strength and function after artery healing.
Rarely if the limb has to amputated Dr Bala can organize for artificial limb prostheses to match the colour size and texture of the opposite hand
