Combat Forearm Arterial Injuries: A Case Series

High-energy combat trauma often results in injuries to both the radial and ulnar arteries, accompanied by extensive soft tissue loss and a low probability of sufficient collateral flow.

A case series of 28 male patients with acute forearm arterial injuries from combat trauma was reviewed. Surgical approaches included ligation, end-to-end anastomosis, and autologous vein grafting. Temporary shunting was employed in select cases. The clinical outcomes were assessed.

Among 28 cases, 26 achieved successful hand salvage. Complications included one graft thrombosis (leading to amputation) and one death. Good late outcomes were achieved in 60% of cases.

Repair of at least one forearm artery is essential in dual injuries. Autologous vein grafting is preferred for combat trauma. Mangled Extremity Severity Score may not reliably predict amputation. Temporary shunts can be effectively utilized with appropriate adjuncts.