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Determinates of functional disability after complex upper extremity trauma.

K R Brown1, J Jean-Claude, G R Seabrook

  • 1Department of Vascular Surgery, Medical College of Wisconsin, Milwaukee, USA.

Annals of Vascular Surgery
|February 28, 2001
PubMed
Summary

Upper extremity arterial trauma, often from penetrating injuries, can lead to significant disability. Associated nerve and orthopedic injuries negatively impact functional recovery, highlighting the importance of comprehensive assessment.

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Area of Science:

  • Vascular Surgery
  • Trauma Surgery
  • Orthopedic Surgery

Background:

  • Upper extremity arterial trauma presents a significant challenge in surgical management.
  • Understanding injury patterns and associated factors is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To review surgical outcomes for upper extremity arterial trauma.
  • To identify factors influencing functional recovery and limb salvage.

Main Methods:

  • Retrospective chart review of 71 patients operated on for upper extremity arterial trauma (June 1992 - June 1998).
  • Analysis of injury types (penetrating vs. blunt), specific arterial locations, associated injuries (orthopedic, neurologic), and surgical outcomes.
  • Statistical analysis to determine factors affecting functional outcome.

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Main Results:

  • A total of 71 patients with various arterial injuries (brachial, axillary, subclavian, etc.) were analyzed.
  • The overall patency and limb salvage rate was 94%, with 3 thromboses, 1 disruption, and 4 amputations.
  • Associated orthopedic and neurologic injuries significantly increased the risk of persistent disability (p < 0.05).

Conclusions:

  • While limb salvage rates are high (94%), functional recovery remains a concern, with 67% experiencing some disability.
  • Blunt trauma and combined neurologic/orthopedic injuries are associated with poorer functional outcomes.
  • The severity of neurologic injury is a primary determinant of functional outcome in upper extremity arterial trauma.