Arch Hand Microsurg.  2022 Dec;27(4):292-295. 10.12790/ahm.22.0039.

Vascular malformation in the hand causing adduction contracture of the thumb: a case report

• Park HW
• Park JW
• Kim L
• Park IJ
• Oh S
• Kim JY
• Kang SH

• KMID: 2536214
• DOI: http://doi.org/10.12790/ahm.22.0039

Abstract

Vascular malformations of the muscle are rare non-proliferative vascular lesions, and few case reports have described intramuscular vascular malformations in the upper extremities. Vascular malformations of the muscle may produce musculoskeletal deformities due to muscle contracture. Symptomatic intramuscular vascular malformations are commonly treated with surgery and interventional management. We report a vascular malformation that could not be completely resected. It caused adduction contracture of the thumb in the hand. Sclerotherapy was performed before surgery, but the contracture did not improve. Thus, we additionally performed adductor tenotomy. There was no evidence of recurrence during 6 months of follow-up.

Keyword

Hand; Thumb contracture; Vascular malformations; Sclerotherapy; Tenotomy

Figure

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  Fig. 1. Thumb adduction and flexion contracture.

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  Fig. 2. The 1st web space calcific material deposit found on simple X-ray.

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  Fig. 3. Magnetic resonance imaging T2-weighted fat suppression image. Thenar muscles and adductor pollicis (A), and 1st web space interosseous muscles (B) were invaded by lobular lesion.

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  Fig. 4. Adductor pollicis invaded by vascular malformation. With thumb range of motion, tightening lesion of adductor lesion was checked with freer.

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  Fig. 5. (A) After adductor tenotomy. (B) Six months after surgery.

Reference

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