Work

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

Year: 2026

Type: review

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.

Source: Cureus

DOI: 10.7759/cureus.117758