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Vascular malformations of the upper extremity continue to be a therapeutic challenge to the hand surgeon. In the past 22 years, the authors treated 17 patients with major vascular malformations of the upper extremity. The lesions were evaluated with the aid of plain radiographs, angiography, and histology. Thirteen of the oatients were female and 4 were male. The average age at treatment was 18 years, ranging from birth to 64 years. The average follow-up period was 12 years, ranging from 4 months to 96 years. The main indications for surgery were pain, progressive enlargement, neurologic compromise, diminished function, or a combination of these. The progression of these lesions under observation led to surgical management in all cases. A total of 36 excisions, 3 embolizations, and 4 amputations were done. Postoperative angiograms were obtained in selected individuals. Diffuse lesions defied total surgical removal. Recurrence and persistence was evident in 12 of the 17 patients. A knowledge of the progressive nature of these lesions and the need for long-term observation are the keystones to the successful management of these challenging yet unresolved problems.
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Accepted: May 15, 1996
Received: October 14, 1994
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
© 1997 The American Society for Surgery of the Hand. All rights reserved. Published by Elsevier Inc.