Dry Gangrene of Hand Secondary to Repetitive Intravenous Drug Abuse: A Case Series.

Introduction: Inadvertent intra-arterial drug injection is a serious complication of intravenous (IV) drug use that can lead to severe vascular damage, including ischemia, gangrene, and amputation. Although such cases are well-documented, there is limited emphasis on the importance of early diagnosis and intervention in preventing severe outcomes. This case series reports on patients who experienced gangrene of the upper limbs as a result of IVintravenous drug use, highlighting the significant clinical consequences of delayed treatment. Case Report: We present a series of five male patients aged 21 to -30 years who presented with upper limb gangrene caused by repetitive IVintravenous drug use. The patients, all of whom were positive for human immunodeficiency virus HIV or Hepatitis C, had varying durations of drug abuse, with their symptoms ranging from 10 to 30 days before presentation. The clinical findings included dry gangrene, pain, and blackening of fingers, requiring surgical interventions such as partial or complete amputation. Diagnostic imaging such as Doppler ultrasound and computed tomography CT angiography was not performed in some cases due to patient refusal or financial constraints. Conclusion: This case series emphasises emphasizes the critical need for early recognition and timely intervention in cases of IVintravenous drug-induced ischemia. Surgical management was necessary in all cases, but earlier medical treatments, including vasodilators and thrombolytics, may have improved outcomes. This report serves to increase awareness of the complications associated with IVintravenous drug use. It underscores the need for healthcare providers to be vigilant in promptly diagnosing and managing such cases. The clinical impact extends beyond orthopaedics, contributing to the broader understanding of vascular complications related to IVintravenous drug abuse.