The acute blue finger: management and outcome.

Journal article

INTRODUCTION: The objective was to assess the management, and short- and longer-term outcome of patients presenting with an acute blue finger. PATIENTS AND METHODS: This was a retrospective, case-note review and prospective follow-up by telephone and general practitioner enquiry. All patients who presented with sudden onset blue discolouration of a finger within the previous 72 h, with normal radial and ulnar pulses, were included. RESULTS: From 2000 to 2006, 22 patients, 15 female, 7 male, were reviewed. Median age was 56 years (range, 19-88 years). Median time from onset of blue finger was 6 days (range 1 day to 3 months). In most cases (17), no underlying cause was identified. Five patients had an underlying cause; two had symptoms compatible with Raynaud's phenomenon, one patient had signs (later confirmed on MRA) of arterial thoracic outlet syndrome and two had polycythaemia (haemoglobin > 17 g/dl). Otherwise, all laboratory investigations were normal. Upper limb duplex, echocardiogram and 24-h cardiac tapes were normal in all cases. Median follow-up was 19 months. Three patients had recurrent symptoms in the finger. No patient suffered tissue loss or loss of digit(s), and none had stroke or arterial embolisation. CONCLUSIONS: The acute blue finger is a benign condition not suggestive of arterial embolisation. Tissue or digit loss is not a threat and, in the longer term, there is no threat of embolisation to other vascular sites.

Authors: Cowen, R; Richards, T; Dharmadasa, A; Handa, A; Perkins, J

• Publication status: Published
• Journal: Annals of the Royal College of Surgeons of England
• Volume: 90
• Issue: 7
• Pages: 557-560
• Publication date: 2008-10-01
• DOI: 10.1308/003588408x318237
• EISSN: 1478-7083
• ISSN: 0035-8843
• Language: English
• Keywords: Aged, 80 and over; Fingers; Aged; Follow-Up Studies; Female; Middle Aged; Young Adult; Humans; Adult; Ischemia; Acute Disease; Treatment Outcome; Male