Thumb blood flow, the resurgence of anatomy
The results of a recent study performed by two UN doctors provides tools for trauma management of the finger which performs 40% of the hands’ functions.Bogotá D. C., 27 de marzo de 2012 — Agencia de Noticias UN-
Sandra Milena González and Adriana Rocío Ramírez, UN surgeons. Photo: Courtesy of Sandra Milena González.
In the pre-historical age, disease and pain were blamed on deities, extraordinary phenomena or as punishment imposed by evil beings. Autopsies, however, have altered man’s beliefs on the subject. It has since been learned that the suffering is due to problems coming from within the body.
From that moment on, there has been a transformation in perception, and anatomy has been a highly valued discipline in medicine. It has become so important that medical students have had to study at least two years of human anatomy, and it’s been considered vital that every teaching facility have a good morgue. As a result, when the UN was conceived, the first order of business for the Medical faculty was to upgrade San Juan de Dios’ morgue.
When physiology came into the picture, anatomy study in universities was relegated to a more minor status. Anatomy departments were reduced to half their size as it was assumed that everything had already been discovered and said. Recently a UN Plastic Surgeon postgraduate student, Sandra Milena González, and Adriana Rocío Ramírez, a UN professor and project director, have proved this theory wrong.
After evaluating the literature, these doctors have found several differences in nomenclature, and varied descriptions of thumb blood flow. From this they have begun a descriptive anatomical study of the thumb.
"We used the vascular injection technique, which had not been previously mentioned in the literature for this use, but which was widely used in plastic surgeries performed at UN a few years back. This technique consists of injecting methyl methacrylate and Indian ink, which enables the assessment of very small blood vessels", explained Dr. González, who currently works in the Clínica Colombia, at the Clínica Reina Sofía, with the Red Cross and at her own medical practice.
For this research, 37 right hands were evaluated (although only 30 were included in the final results). A vascular injection was given to the radial artery with the purpose of assessing the arterial blood flow to the thumb.
Findings concerning blood flow were descriptive in nature, said the doctor, and have mainly helped to determine that the thumb, being the most important finger for hand function, has a very rich blood flow. "What we’re looking for is to maintain the vitality of the finger at all costs", said the researcher.
"We also found a prevalence of blood circulation in the palm in contrast to the dorsal side of the hand. When a patient has undergone severe trauma to the hand, providing care to palm arteries will maintain the vitality of the thumb", said González.
In addition, added the doctor, there is greater ulnar circulation in contrast to radial circulation. This upholds the theory that the ulnar area is dominant not only related to sensitivity, but also in blood flow to the thumb.
"Having an anatomical base is the fundamental stepping stone of any of the branches in medicine, and even more so in surgical areas, as these anatomical findings will be instrumental in becoming acquainted with the blood circulation of the thumb. If reconstructive surgery is needed we can perform a flap surgical procedure to cover the area, and have a base for reconstructive techniques on hand traumas", added the surgeon, who during the three years of the study, had the support of the Bogotá Forensic Medicine Institute (Instituto de Medicina Legal) and plastic surgery professors.
An article was published on this study in the March edition of Plastic and Reconstructive Surgery, the most important plastic surgery journal in the world. One of the photographs related to the story was chosen for the front page of the Journal.
Two thumbs up for these medical professionals who, due to their research, are today recognized for reviving the interest in anatomy, and for further increasing pride.(Por: Fin/dpr/clc