Chase’s amputation of index finger due to ischemia caused by Buerger's disease

This case report describes a 52-year-old chronic smoker with Buerger’s disease (thromboangiitis obliterans) who presented with gangrene of the index finger. Buerger’s disease, a nonatherosclerotic inflammatory condition affecting small- and medium-sized arteries, is strongly associated with tobacco use. The patient, who had a history of thumb amputation due to the same condition, underwent a Chase amputation of the index finger. This procedure involves amputation at the base of the second metacarpal, allowing for the preservation of hand function, particularly the pollicidigital grip, while maintaining aesthetic appearance. The discussion highlights the functional importance of the index finger and the role of amputation in cases where significant tissue damage occurs. Buerger’s disease, primarily affecting young male smokers, lacks definitive treatment other than absolute smoking cessation. Surgical interventions like bypass are often ineffective due to the disease’s progression and distal arterial involvement. In conclusion, Chase amputation proved to be a functionally effective intervention for this patient, restoring hand grip and addressing the complications of Buerger’s disease. The case underscores the critical need for smoking cessation to prevent disease progression and the importance of tailored surgical approaches in managing severe digital ischemia.