The characteristics and outcomes of vascular abnormalities involving limbs in children: a retrospective analysis of 35 cases.

OBJECTIVE

To explore the clinical characteristics, diagnostic criteria, and surgical outcomes of vascular abnormalities in the limbs of children.

METHODS

The clinical data of children diagnosed with pathologically confirmed limb vascular abnormalities at Hunan Children's Hospital from January 2007 to December 2025 were retrospectively analyzed. Demographic data including pathological types, lesion locations, clinical manifestations, surgical procedures and therapeutic outcomes were summarized.

RESULT: Among the 35 children, 18 (51.4%) were male and 17 (48.6%) were female. The age at surgery was 1.8 to 14.2 years, with an average of (7.4 ± 3.2) years. Lesions involved the upper limbs in 16 cases and the lower limbs in 19 cases. The main clinical manifestations were localized masses in 32 cases (91.4%), pain in 19 cases (54.3%), joint dysfunction in 3 cases (8.6%), limping in 2 cases (5.7%), and skin ulcers in 1 case (2.9%). The size of the masses ranged from 1.0 to 9.6 cm, with an average of (3.8 ± 2.3) cm. Three cases (8.6%) had a history of multiple interventional embolization or sclerotherapy injections. Two cases (5.7%) had undergone previous resection surgery in other hospitals. All cases were treated with surgical excision in our department. Pathological types revealed venous malformation (VM) in 14 cases (40.0%), arteriovenous malformation (AVM) in 12 cases (34.3%), lymphangioma (LM) in 5 cases (14.3%), and intermuscular hemangioma (IH) in 4 cases (11.4%). All patients were followed up, with an average postoperative follow-up period of 0.3 to 18.2 years (mean: 6.4 ± 4.5 years). One case developed finger extension restriction and scar contracture, two cases had elbow extension restriction, two cases experienced local recurrence, and there were no cases of skin necrosis or infection. The surgical complication rate was 11.4%, and the recurrence rate was 5.7%. There was no significant difference in complication rate and recurrence rate among different pathological types (P = 0.283 and P = 0.176 respectively).

CONCLUSION

The main clinical manifestations of vascular abnormalities in pediatric limbs include local masses and pain. Surgical resection can be adopted for localized, well-demarcated limb vascular malformations as well as cases failed to interventional therapy, yielding promising clinical outcomes with a low recurrence rate and reliable preservation of limb function.