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Related Experiment Videos

Complex upper extremity vascular trauma in an urban population.

S I Myers1, T R Harward, D P Maher

  • 1Department of Surgery, University of Texas Medical School, Houston 77030.

Journal of Vascular Surgery
|September 1, 1990
PubMed
Summary

This study highlights effective management of upper extremity vascular trauma, emphasizing prompt diagnosis and surgical repair. Aggressive treatment, including fasciotomy and debridement, led to successful outcomes with no amputations.

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Area of Science:

  • Vascular Surgery
  • Trauma Surgery
  • Orthopedic Surgery

Background:

  • Upper extremity vascular trauma presents complex challenges.
  • A significant number of injuries involve both arterial and venous systems.
  • Associated nerve, bone, and soft tissue injuries are common.

Purpose of the Study:

  • To evaluate the outcomes of treating upper extremity vascular trauma.
  • To identify effective surgical techniques and management strategies.
  • To support an aggressive approach to diagnosis and treatment.

Main Methods:

  • Retrospective analysis of 80 patients with 123 vascular injuries over 4 years.
  • Documented injury types (penetrating, blunt, iatrogenic) and affected vessels (ulnar, radial, brachial, subclavian, axillary).

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  • Recorded associated injuries and surgical repair methods (end-to-end anastomosis, vein grafting, fasciotomy).

    • Main Results:

    • Most injuries were arterial (95/123), primarily affecting ulnar and radial arteries.
    • High rates of associated nerve (53) and soft tissue (60) injuries were observed.
    • Successful arterial repair rates were high, with no required amputations and significant nerve deficit improvement (83%).

    Conclusions:

    • An aggressive diagnostic and treatment strategy is crucial for complex upper extremity vascular trauma.
    • Meticulous surgical technique, liberal fasciotomy use, and aggressive debridement are key.
    • Timely repair of associated injuries improves overall patient outcomes.