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Vascular complications associated with orthopedic procedures.
J A Freischlag1, M Sise, W J Quinones-Baldrich
1Department of Surgery, University of California, San Diego 92103.
Surgery, Gynecology & Obstetrics
|August 1, 1989
Summary
Orthopedic procedures can cause rare but serious vascular injuries. Prompt recognition and treatment are crucial for optimal outcomes, preventing complications like ischemia.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Trauma Surgery
Background:
- Vascular injuries during orthopedic procedures are infrequent but critical events.
- Timely recognition and intervention are essential for patient outcomes.
Observation:
- A review of 11 vascular injuries from orthopedic procedures between 1978-1988.
- Injuries involved iliac, popliteal, brachial, and femoral arteries, as well as iliac veins.
- Procedures included lumbar laminectomy, hip replacement, fracture fixation, and humeral fracture reduction.
Findings:
- Arterial injuries were managed with primary repair or bypass grafts.
- Venous injuries were repaired primarily or treated with a filter for thrombosis.
- Diagnostic delay was a significant factor in major complications, primarily ischemia.
Implications:
- Vascular injuries can result from laceration, compression, or traction due to anatomical proximity.
- Hemorrhage and ischemia are primary manifestations of these injuries.
- Prompt diagnosis and treatment, along with pre-operative vascular assessment, improve results.