Arterial thrombosis in a replanted thumb due to factor V mutation and anti-phospholipid antibodies

摘要

Dear Sir, We present a case study of a replanted thumb not surviving due to a coagulation disorder. The patient had an underlying factor V Leiden mutation and was positive for anti-phospholipid antibodies, both of which result in a pro-thrombotic tendency. This became a recurring problem during the replant with each arterial anastomosis complicated by repeated bouts of thrombosis. To our knowledge this is the first reported case of a replant failure due to arterial thrombosis associated with factor V mutation. A 40-year-old male presented with traumatic amputation of his dominant left thumb by a telescopic band saw. The thumb was amputated at the level of the metacar-pophalangeal joint. The injury was single level, 4 mm proximal to the head of the first metacarpal, with the mechanism causing some crush of tissues proximally and distally creating a zone of injury approximately 20 mm long. The patient reported no significant medical history and was an ex-smoker.