MY 11 YEAR OLD SON JUST GOT DIAGNOSED BY A HAND SURGEON WITH AN ANEURYSM OF THE PALMER ARCH. I KNOW THIS IS VERY RARE AND VERY FEW CHILDREN HAVE HAD IT IN MEDICAL HISTORY, AND ONLY A HANDFUL OF ADULTS. I HAVE NO IDEA WHAT TO DO. EVEN HIS PRIMARY DOCTOR AGREE'S THAT THE HAND SURGEON IS NOT THE RIGHT ONE FOR THE SURGERY BECAUSE IT MAY REQUIRE RECONSTRUCTIVE SURGERY OF THE VEINS WITH MICROSURGERY AMONG OTHER THINGS. BUT THERE ISNT ANYONE THAT I HAVE SPOKEN WITH WHO KNOWS ANYTHING ABOUT THIS INJURY. IN ADDITION, ALL THE KNOWN MEDICAL CASES IN CHILDREN OR ADULTS SEEM TO HAVE HAPPENED AFTER SURGERY OR FROM A BLUNT FORCE TRAUMA. MY SONS WAS BLUNT FORCE TRAUMA, BUT WHAT MAKES HIM DIFFERENT IS THAT HIS SKIN WAS NOT TORN OR CUT DURING TRAUMA, THERE WAS NO ABRASION AT ALL. IN FACT, HE MANAGED TO DO THIS UP IN HIS ROOM WHILE PLAYING AROUND WITH HIS FIVE YEAR OLD BROTHER. I HAVE DONE MY RESEARCH AND MY FINDINGS OF A TOTAL OF EIGHT PEOPLE HAVE HAD THIS TYPE OF ANEURYSM IS MEDICAL HISTORY THAT WAS RECORDED. THREE CHILDREN AND FIVE ADULTS. IN MY RESEARCH THERE IS ONLY ONE RECORD OF THIS BLUNT FORCE TRAUMA WITHOUT SKIN ABRASION I COULD FIND, AND IT HAPPENED TO A RAILROAD WORKER IN 1911. PLEASE DIRECT ME TO THE RIGHT SURGEON. IT WOULD BE IDEAL IF I COULD TAKE HIM TO A SURGEON WHO HAS EXPERIENCE WITH THIS TYPE OF ANEURYSM, BUT I KNOW THAT MIGHT NOT BE POSSIBLE. THANK YOU
Answer Although rare, as mentioned this can happen with sufficient force to the hand. The child needs an angiogram or MRA to evaluate the communicating vascular components, if not already done. Given the age of the child it is important to determine if this is a pseudo aneurysm vs real (more likely pseudo since related to trauma). Since the hand is supplied by both the radial and ulnar arteries, the anatomic distribution of supply of the aneurysm is important because it can potentially be embolized if digital arteries are not supplied by the injured area. Otherwise, a team approach to the repair may be necessary. Biggest thing is imaging to see whats damaged then I could render more repair/fix discussions.
this is from a terrific vasc surgeon in Oklahoma
I can answer your questions related to your circulation, your peripheral vascular system. This includes all arteries and veins except those inside the head and inside the heart. For example, neck (carotid), arms (carotid subclavian bypasses to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Arterial Bypass, Reynaud’s, Buerger's disease (thromboangiitis obliterans), Thoracic Outlet and other circulation disorders. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wounds from diagnosis to treatments. I have worked extensively with VNUS Closure and EVLT (Laser) for varicose veins and can describe pre and post procedure expectations and describe the procedures themselves. I can't help with spider veins or cosmetic vein treatment, we don't do it. I have 15 years of wound care experience, arterial, venous, trauma and diabetic wounds for example.
**I CANNOT answer questions about STENTS or STENTING, heart disease, blood pressure, brain aneurysm although I can help with questions about the arteries that go to and from those organs.
I am a nurse, I worked for 15 years with two terrific peripheral vascular surgeons, and one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage the clinic website and field questions from patients all over the world. I am now working with another vascular surgeon and wound care expert, which has given me an opportunity to widen my horizons as I learn another excellent physician's preferences and benefit from his experiences in this amazing specialty.
Education/Credentials I am an LPN, licensed in Minnesota