Arterial Injury in the Upper Limb Resulting from Dog Bite.

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Orthopedic Surgery

Background:

• Dog bites to the upper extremities pose a significant risk of deep tissue and arterial injury, despite small puncture wounds.
• Limited data exists on the specific incidence and management of arterial injuries resulting from dog bites in the upper limb.

Observation:

• A case of a 32-year-old male with brachial artery puncture and spasm from a dog bite successfully treated with a jump bypass graft using the cephalic vein.
• Literature review identified 34 cases of upper limb arterial injury from dog bites, with axillobrachial arteries most commonly affected (65%).

Findings:

• Diminished pulses were the most common presentation (45%).
• Arterial thrombosis (29%), transection (15%), and intimal tears (9%) were noted injury types.
• Interposition grafts (47%) and primary repair (20%) were common surgical interventions.

Implications:

• Highlights the critical need for prompt diagnosis and surgical intervention in upper extremity dog bite vascular injuries.
• Emphasizes the potential for residual neurological deficits, underscoring the importance of comprehensive patient follow-up.
• Suggests that advanced surgical techniques, such as bypass grafting, are effective in managing severe brachial artery injuries from dog bites.