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Traumatic arterial injuries of the upper extremity: determinants of disability
Insights
Upper extremity vascular injuries, primarily from gunshot wounds to the brachial artery, often lead to disability. Primary repair was common, but nerve damage significantly impacted function, with brachial artery injuries causing the most severe outcomes.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Orthopedic Surgery
Background:
- Vascular injuries are a significant cause of morbidity and mortality.
- Upper extremity injuries present unique challenges in diagnosis and management.
- Understanding injury patterns and outcomes is crucial for improving patient care.
Purpose of the Study:
- To analyze the incidence, causes, and outcomes of upper extremity vascular injuries.
- To identify factors contributing to disability and limb loss.
- To evaluate the effectiveness of primary repair in managing these injuries.
Main Methods:
- Retrospective review of 233 patients with vascular injuries over 13 years.
- Specific focus on 99 patients with upper extremity involvement.
- Analysis of injury site, cause, treatment, and functional outcomes.
Main Results:
- 99 of 233 vascular injuries involved the upper extremity, predominantly the brachial artery (43 patients) due to gunshot wounds.
- Most injuries underwent primary repair.
- Nerve injuries (56 patients) were the main cause of disability; edema and infection were not significant factors.
- Gunshot wounds to the brachial artery had the highest incidence of disability and limb loss.
Conclusions:
- Gunshot wounds are a major cause of severe upper extremity vascular trauma.
- Nerve injury is a critical determinant of long-term disability following vascular trauma.
- Prompt surgical intervention and comprehensive management are essential for optimizing functional outcomes.
Abstract:
Of 233 patients who sustained vascular injuries during a 13 year period, 99 had involvement of the upper extremity. The primary site of upper extremity injuries was the brachial artery (43 patients), and the primary cause of injury was gunshot wounds. The majority of the vascular injuries were repaired primarily. Nerve injuries occurred in 56 of the patients, and they were the primary cause of disability. Edema and infection were not significant determinants of limitations in function. Gunshot wounds to the brachial artery resulted in the highest incidence of disability and limb loss.