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Paediatrics
Incomplete superficial palmar arch and gangrene in the hand in a neonate with DOCK6 mutation
  1. Aisha Naaz1,
  2. Shahbaj Ahmad2,
  3. Saikat Patra3 and
  4. Girish Gupta3
  1. 1Paediatric Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
  2. 2General Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
  3. 3Neonatology, Himalayan Institute of Medical Sciences, Dehradun, India
  1. Correspondence to Dr Girish Gupta; dscnnf{at}gmail.com

Abstract

The superficial palmar arch, formed by the branches of radial and ulnar arteries, supplies the blood to the hand. In cases of incomplete superficial palmar arch, the radial and ulnar branches fail to join. Any compromise to the ulnar blood supply in an incomplete superficial palmar arch can lead to subsequent gangrene. This baby presented with blackish discolouration and gangrene on the left hand, primarily affecting the little, ring, middle and index fingers. Timely intervention with antibiotics and heparinisation led to salvage of the ring, middle and index fingers, while the little finger underwent auto-amputation. On clinical exome sequencing, the baby was found to have DOCK6 mutation. This case highlights the importance of vascular involvement in DOCK6 mutation and the need for careful evaluation and management in cases of incomplete superficial palmar arch.

  • Anatomic Variation
  • Arteries
  • Paediatrics
  • Radiology
  • Thrombosis

https://doi.org/10.1136/bcr-2024-261264

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: AN, SA, SP and GG. The following authors gave the final approval of the manuscript: AN, SA, SP and GG. The guarantor is GG.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.