Vascular malformations of the hand (retrospective study)

Vascular malformations of the hand can create challanging problems for hand surgeons. Aim of this study was to analyse our treatment results retrospectively and suggest some guidelines regarding indication and technical performance of the operation. Methods: Files of 42 patients with vascular malformations of the hand were analysed retrospectively between 1992 and 2002. Results: 22 patients were classified as having fast flow malformations, 20 patients having slow flow malformations. Conclusion: Slow flow vascular malformations have usually a good prognosis. Fast flow malformations can create difficult problems. A conservativ approach should always be applied first, because operative therapy results only exceptionally in complete recovery, but recurrence and complications are quite usual. In some diffuse cases amputation gives a much better quality of life than repeated operations without any functional gain. Endovascular embolisation with different agents is an other possibility being done preoperatively or also alone as a palliative treatment. We are quite careful with the indication of endovascular embolisation. We do think that future development is going to be based on new, more safe embolisation techniques, and further refinements of the operative techniques.