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Overview of extremity arterial trauma in Jordan
H A Heis1, K E Bani-Hani, M A Elheis
1Department of Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Insights
Vascular trauma in extremities, often from penetrating injuries, led to significant disability and amputation. Delays in surgery and combined orthopedic injuries increased amputation risk, highlighting the need for prompt treatment.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Orthopedic Surgery
Background:
- Extremity vascular injuries pose significant challenges in trauma care.
- Understanding etiologies and outcomes is crucial for effective management.
Purpose of the Study:
- To review the causes, injuries, diagnosis, management, and outcomes of extremity vascular trauma.
- To identify treatment factors influencing the outcome of injured extremities.
Main Methods:
- Retrospective analysis of 73 patients with upper and lower limb arterial injuries (2001-2006).
- Evaluation of demographic data, injury mechanisms, vessel location, associated injuries, treatment, and outcomes.
Main Results:
- Penetrating injuries were the most common cause (52%), affecting femoral and brachial arteries.
- Associated orthopedic (29%) and nerve (25%) injuries were frequent.
- Amputation occurred in 7% of cases, with a 7% mortality rate.
Conclusions:
- Delayed surgery, blunt trauma, and extensive soft tissue defects in combined injuries increase amputation risk.
- Associated nerve and bone injuries with soft tissue damage predict poor outcomes.
Aim:
The objectives of this study were to review etiologies of trauma, associated injuries, diagnosis, management, and outcomes of patients with vascular injuries in the extremities and relate factors in their treatment to the outcome of the injured extremity.
Methods:
Data were collected retrospectively on 73 patients diagnosed to have upper and lower limbs arterial injuries at King Abdullah University Hospital, Jordan, between 2001 and 2006. Factors evaluated included demographic data, location of vessels injured, mechanism of injury, associated injuries, treatment, and outcome.
Results:
Patients were predominantly males (54 patients). Isolated vascular trauma was present in 36 patients, while in the remaining 37 patients vascular trauma was aggravated by concomitant injuries. The most common etiology of vascular injuries in the upper and lower extremities was a penetrating injury found in 38 patients (52%). The vessels most commonly involved were the femoral and brachial arteries. Various associated injuries were identified mainly orthopedic in 21 patients (29%) and nerve injuries in 18 patients (25%). Autogenous vein graft interposition was mostly performed in 32 patients (44%). Permanent disability was seen in 8 patients (11%), limb amputation was performed in 5 patients (7%). Five patients died due to associated intraabdominal, thoracic, and head injuries giving a mortality rate of 7%.
Conclusions:
Delay in surgery, blunt trauma and extensive soft tissue defect in combined orthopedic and vascular injuries were associated with increased risk of amputation, while associated nerve injuries and bone injuries with extensive soft tissue damage are risk factors of poor quality outcome.
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