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Peer-reviewedCC BYCureus

Management of Traumatic Arterial Injuries of the Hand and Digits in the Emergency Department: A Systematic Review.

  • Mazin Osman1
  • Syeda Maida Mujahid2
  • Osama Ali3
  • Shenouda R Shehata Abdelmesih4
  • Saad Ali5
  • Shashwat Shetty6
  • Hira Khan7
7 affiliations
  1. 1General Surgery, British United Provident Association, Jeddah, SAU.
  2. 2Orthopaedics and Traumatology, Luton and Dunstable Hospital, Luton, GBR.
  3. 3Emergency Medicine, University Hospital Limerick, Limerick, IRL.
  4. 4Orthopaedics and Trauma, Royal Gwent Hospital, Newport, GBR.
  5. 5Emergency Medicine, Nishtar Hospital, Multan, PAK.
  6. 6Orthopaedics, Hillingdon Hospital, Uxbridge, GBR.
  7. 7Medicine, Jinnah Sindh Medical University, Karachi, PAK.
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Abstract

Traumatic arterial injuries of the hand are uncommon but may threaten digit viability and function, while the optimal indications for vascular reconstruction remain uncertain. A systematic literature search of PubMed or MEDLINE, Scopus, Embase and Cochrane Library was performed between 2 April and 30 July 2026 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Studies evaluating traumatic arterial injuries confined to the hand and digits were eligible. Of 98 records identified, six studies met the inclusion criteria, comprising approximately 546 patients across the included cohorts. Evidence supported revascularisation of threatened or ischaemic digits, with primary repair preferred when a tension-free anastomosis was achievable and interposition vein grafting used for segmental defects. In adequately perfused digits, isolated digital arterial injury did not consistently require reconstruction. Dual arterial reconstruction improved objective perfusion but did not demonstrate a consistent functional advantage, while artery-only replantation showed acceptable survival in selected distal amputations. Management should be individualised according to perfusion, mechanism and extent of arterial injury. Current evidence is predominantly observational and heterogeneous, supporting the need for prospective multicentre comparative studies.

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Cite

BibTeXRIS
BibTeX
@article{osman2026management,
  title = {{Management of Traumatic Arterial Injuries of the Hand and Digits in the Emergency Department: A Systematic Review.}},
  author = {Mazin Osman and Syeda Maida Mujahid and Osama Ali and Shenouda R Shehata Abdelmesih and Saad Ali and Shashwat Shetty and Hira Khan},
  journal = {Cureus},
  year = {2026},
  month = oct,
  doi = {10.7759/cureus.117758},
  url = {https://europepmc.org/article/MED/43011759},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Management of Traumatic Arterial Injuries of the Hand and Digits in the Emergency Department: A Systematic Review.
AU  - Mazin Osman
AU  - Syeda Maida Mujahid
AU  - Osama Ali
AU  - Shenouda R Shehata Abdelmesih
AU  - Saad Ali
AU  - Shashwat Shetty
AU  - Hira Khan
PY  - 2026
DA  - 2026/10/11
JO  - Cureus
DO  - 10.7759/cureus.117758
UR  - https://europepmc.org/article/MED/43011759
AB  - Traumatic arterial injuries of the hand are uncommon but may threaten digit viability and function, while the optimal indications for vascular reconstruction remain uncertain. A systematic literature search of PubMed or MEDLINE, Scopus, Embase and Cochrane Library was performed between 2 April and 30 July 2026 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Studies evaluating traumatic arterial injuries confined to the hand and digits were eligible. Of 98 records identified, six studies met the inclusion criteria, comprising approximately 546 patients across the included cohorts. Evidence supported revascularisation of threatened or ischaemic digits, with primary repair preferred when a tension-free anastomosis was achievable and interposition vein grafting used for segmental defects. In adequately perfused digits, isolated digital arterial injury did not consistently require reconstruction. Dual arterial reconstruction improved objective perfusion but did not demonstrate a consistent functional advantage, while artery-only replantation showed acceptable survival in selected distal amputations. Management should be individualised according to perfusion, mechanism and extent of arterial injury. Current evidence is predominantly observational and heterogeneous, supporting the need for prospective multicentre comparative studies.
SN  - 2168-8184
ER  -