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Traumatic lower extremity arteriovenous fistulae in children

Andrea L Bowers1, Severino R Bautista, Rocco Bassora

  • 1Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104-4399, USA.

Orthopedics
|March 19, 2009
PubMed

Insights

Traumatic arteriovenous fistulae in children are rare, often missed non-penetrating injuries or post-surgical complications. Early recognition of subtle signs is crucial for timely intervention in pediatric vascular trauma.

Area of Science:

  • Vascular Surgery
  • Pediatric Trauma
  • Arteriovenous Fistula

Background:

  • Traumatic arteriovenous fistulae (AVFs) are uncommon in children.
  • Most pediatric AVFs result from penetrating trauma or surgical procedures.
  • Non-penetrating injuries can lead to AVFs that are often initially overlooked.

Observation:

  • AVFs from non-penetrating injuries may lack obvious clinical signs of vascular damage.
  • Post-surgical vascular injuries can present with symptoms mimicking normal postoperative discomfort.
  • Unusual presentations of vascular injury require heightened clinical suspicion in pediatric patients.

Findings:

  • This article reviews pediatric lower extremity vascular complications, including AVFs, from blunt trauma and surgery.
  • Cases presented occurred between November 2004 and December 2005.
  • Focus is on challenges in early diagnosis and management.

Implications:

  • Emphasizes the need for vigilance among clinicians for subtle vascular injuries in pediatric trauma.
  • Highlights the importance of considering AVFs in pediatric patients with unexplained lower extremity symptoms post-injury or surgery.
  • Suggests improved diagnostic strategies may be needed for non-penetrating vascular trauma in children.

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