Duplex ultrasound analysis of hemodynamic changes following microsurgical repair of unilateral digital artery injuries: a retrospective follow-up study.

BACKGROUND

Whether unilateral digital artery injuries benefit from surgical repair remains controversial, as perfusion is typically preserved by the remaining, contralateral artery. Evidence on the long-term patency and hemodynamic effects of reconstructed unilateral arteries is limited. This study aimed to evaluate the patency and flow characteristics of digital arteries after microsurgical repair using duplex ultrasonography.

METHODS

A retrospective single-center study was conducted including patients with unilateral digital artery injuries at the level of the digit who underwent primary microsurgical anastomosis between 2017 and 2022. Patients with fractures, proximal injuries, or vein grafts were excluded. Duplex ultrasonography was used to assess arterial patency and blood flow at follow-up.

RESULTS

Twenty-seven patients were examined at a mean follow-up of 37 months (range 16-82). Duplex ultrasonography demonstrated anterograde flow in 26 of 27 reconstructed arteries (96.3%). The median flow volume in the repaired artery (1.1 ml/min, interquartile range [IQR]: 0.5-2.8) was significantly lower than in the contralateral artery of the same digit (3.6 ml/min, IQR: 1.4-7.7) and the corresponding artery of the contralateral hand (2.8 ml/min, IQR: 1.3-6.8). No significant compensatory increase was observed in the intact artery of the injured digit compared with its contralateral counterpart.

CONCLUSION

Duplex sonography demonstrates that repaired unilateral digital arteries remain patent in the long term, despite reduced flow compared with contralateral controls. While the functional benefit of arterial repair remains uncertain, long-term patency suggests a potential role for repair in selected cases to support vascular integrity.