Management of isolated radial or ulnar arteries at the forearm

The effects of management of single forearm arterial injuries without other associated major muscular, vascular, or neurological trauma were studied. Ninety-six patients with acute injuries to either radial or ulnar arteries without obvious associated major injuries were evaluated. No patient had an ischemic hand secondary to arterial injury. The selection of operative treatment by arterial repair or ligation was by surgeon choice (50 injuries were ligated, and 46 were repaired). Six months to six years postoperative follow-up was done. The overall patency rate for all repaired vessels was 52% (24 cases). The collateral arteries appeared to be a factor causing the low patency rate. The remaining intact artery demonstrated a consistent increase in flow velocity. No subject had hand claudication; there were 51 cases (53%) of hand weakness, 27 incidents (28%) of parasthesia, and 14 incidents (15%) of cold sensitivity independent of patency of the damaged forearm vessel. In the absence of acute hand ischemia, ligation of a lacerated radial or ulnar artery is safe and cost effective.