Arterial combat injuries of the upper extremity

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Orthopedic Surgery

Background:

• Combat injuries frequently affect the upper extremities, posing significant challenges for treatment and functional recovery.
• Delayed treatment, extensive tissue damage, and sepsis are critical factors influencing outcomes in these injuries.

Purpose of the Study:

• To report the treatment outcomes of 101 combat-related upper extremity injuries.
• To identify factors associated with adverse outcomes, including amputation and functional deficits.
• To outline specific management strategies for arterial injuries in the upper extremities.

Main Methods:

• Retrospective review of 101 combat injuries of the upper extremities.
• Analysis of injury types, associated fractures, nerve lesions, and treatment modalities.
• Evaluation of early and late complications, including amputations and functional results.

Main Results:

• 84 acute injuries and 17 late complications were treated.
• High incidence of associated fractures (35%) and nerve lesions (51%).
• Saphenous vein graft replacement was used in over half of the injuries.
• Seven early amputations occurred due to delayed treatment, extensive damage, and sepsis.
• 32 extremities had residual neurologic damage, and two resulted in Volkmann's contracture.

Conclusions:

• Management of combat-related upper extremity arterial injuries requires prompt intervention to prevent severe complications.
• Saphenous vein grafting is a viable option for vascular reconstruction.
• Delayed treatment and sepsis significantly increase the risk of amputation and poor functional outcomes.