AVM HAND

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I have a special interest in AV malformations , when this 25 year old young lady come into my OPD with a hand swelling . She has painful swelling in palm for last 5 years which was static in size for past few years . She had a slight painful swelling which was compressible and no bruit was heard or felt. She showed angiogram which showed that involved carpal arch .

She was operated 0n 17 /9/2016 ,after opening up we found that it was a involving lumbrical muscles . So we excised involved muscle Tourniquet was released and hemostasis was achieved dressing was done and light compression applied . Next day physiotherapy was started. Sutures were removed after 15 days patient had uneventful recovery afterwards.
Excision of AVM , sclerotherapy , embolization are the treatment options for vascular malformation. Morbidity of excision should not be worse than disease itself . Even subtotal excision is better than total excision if safer. Asthetic outcome of scar and function should be prime consideration. Each malformation is assed  and extent of excision and ultimate outcome is important consideration. Nerve damage and vessels damage ,limb loss and massive bleeding are possible poor outcome.
Careful clinical examination , supported by radiological studies will result in a plan which will give good results.


Dr Adhishwar Sharma +91 8860650846 adhishwar@live.com, adhishwar7@gmail.com

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