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Upper-extremity arterial injury

L Pillai1, F A Luchette, K S Romano

  • 1Department of Surgery, State University of New York at Buffalo, 14215, USA.

The American Surgeon
|March 1, 1997
PubMed
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Management of upper-extremity arterial injuries in trauma patients achieved 100% limb salvage. Prompt surgical repair of arterial and nerve damage, with selective venous repair and fasciotomy, leads to good outcomes.

Area of Science:

  • Trauma Surgery
  • Vascular Surgery
  • Orthopedic Surgery

Background:

  • Upper-extremity arterial injuries occur in 3.3% of patients with upper-extremity trauma.
  • Penetrating mechanisms are more common (15/21) than blunt mechanisms (6/21).
  • Associated nerve (9), bone (7), and venous (5) injuries are frequent.

Purpose of the Study:

  • To report current experience in managing upper-extremity arterial injuries.
  • To evaluate outcomes of surgical interventions.
  • To identify factors influencing limb salvage and functional recovery.

Main Methods:

  • Retrospective review of 21 patients with upper-extremity arterial trauma (1992-1994).
  • Analysis of injury mechanisms, patient demographics, involved arteries, and associated injuries.

Related Experiment Videos

  • Surgical management included arterial repair (graft or primary), ligation, nerve repair, venous repair, and fasciotomy.

    • Main Results:

    • 100% immediate limb salvage was achieved.
    • 18 of 20 explored patients underwent arterial repair.
    • One in-hospital mortality (4.7%) from exsanguination and one late motor nerve deficit were reported.

    Conclusions:

    • Upper-extremity arterial injuries can be managed effectively with prompt surgical repair.
    • Angiography may not be necessary for all penetrating injuries.
    • Combined arterial and nerve repair, with selective venous reconstruction and fasciotomy, yields good results.