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Prolonged warm ischemia and limb survival: case report
D B Pilcher1, D Seligson, J H Davis
1Department of Surgery, University of Vermont College of Medicine, Burlington.
The Journal of Trauma
|December 1, 1994
Summary
Severe arm ischemia exceeding 16 hours can be successfully treated with revascularization, preserving hand function and digits. This case study highlights the potential for limb salvage even after prolonged warm ischemia time in extremity injuries.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Trauma Care
Background:
- A 21-year-old female presented with a supracondylar crush injury to her arm, leading to severe limb ischemia.
- Initial brachial artery repair was unsuccessful, resulting in prolonged warm ischemia exceeding 16 hours.
Observation:
- The patient exhibited rigid forearm muscles and inability to passively extend fingers, mimicking rigor mortis.
- Despite the severe presentation, the limb was deemed salvageable.
Findings:
- Secondary revascularization was performed.
- The procedure resulted in a highly functional hand with complete preservation of digits.
Implications:
- Aggressive revascularization attempts in isolated extremity injuries may yield successful outcomes despite extended warm ischemia.
- This case challenges conventional timelines for limb salvage in severe trauma.
- Highlights the importance of considering salvage options even in seemingly non-viable extremities.