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Upper-extremity vascular injuries.

R A McCready1

  • 1Cardiovascular Surgical Associates, Methodist Hospital, Indianapolis, Indiana.

The Surgical Clinics of North America
|August 1, 1988
PubMed
Summary
This summary is machine-generated.

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Upper-extremity injuries, particularly those involving nerves or arteries, can cause significant morbidity. Prompt diagnosis and surgical intervention are crucial for minimizing long-term deficits from these vascular and neurologic injuries.

Area of Science:

  • Orthopedics
  • Vascular Surgery
  • Neurology

Background:

  • Upper-extremity injuries can lead to severe morbidity, especially when nerves or arteries are involved.
  • Collateral circulation in the upper extremity can mask significant arterial injuries, complicating diagnosis.
  • Hematoma compression of the brachial plexus poses a risk of serious neurologic deficits.

Purpose of the Study:

  • To highlight the diagnostic challenges in upper-extremity arterial injuries.
  • To emphasize the importance of prompt surgical intervention for neurovascular compromise.
  • To underscore the impact of nerve injuries on long-term outcomes.

Main Methods:

  • Review of clinical cases involving upper-extremity vascular and nerve injuries.
  • Emphasis on diagnostic modalities, including arteriography.

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  • Discussion of surgical management strategies, including hematoma evacuation.

    • Main Results:

    • Palpable distal pulses may not indicate the absence of proximal arterial injury due to collateral circulation.
    • Early hematoma decompression can significantly mitigate neurologic deficits.
    • The extent of associated nerve injury is the primary determinant of long-term functional outcomes.

    Conclusions:

    • A high index of suspicion and liberal use of arteriography are essential for diagnosing arterial injuries.
    • Aggressive surgical management, including prompt hematoma evacuation, is recommended.
    • Nerve injury associated with vascular trauma significantly influences long-term prognosis.