Clinical Management

Increasing awareness among medical professionals through the dissemination of knowledge about this vascular injury will enable recognition, which is important to prevent the development of an advanced stage of the disease with serious ischemic complications. Invasive treatment options for PCHA aneurysms result in several months of rehabilitation and absence from volleyball activities. However, if PCHA pathology can be detected at an early stage, serious ischemic complications, irreversible tissue damage, and surgical ligation of the PCHA might be prevented. Since volleyball players are considered potentially at risk for developing critical digital ischemia in the spiking hand, analysis of the presence of PCHA pathology, and associated risk factors is warranted for prevention. Ultimately, establishing risk profiles of individual athletes would support clinical management.


Conclusions of the SPIKE study

To optimize care for this potentially limb-threatening vascular overuse injury, and to prevent serious ischemic complications in the spiking hand, clinical management recommendations for individual athletes have been formulated based on the combination of the presence or absence of PCHA pathology, associated risk factors, and reporting of symptoms of digital ischemia (Tables 1 and 3). Conservative management for a PCHA aneurysm with symptomatic emboli in the spiking hand showed promising results in one observed case.


Related articles:

Van de Pol D, Kuijer PPFM, Terpstra A, Pannekoek-Hekman MJC, Alaeikhanehshir S, Bouwmeester O, Planken RN, Maas M. The international SPIKE study on Posterior Circumflex Humeral Artery pathology among elite volleyball players: four profiles for clinical management (4P4M). Submitted. – link expected soon