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Long-term outcomes after upper limb arterial injuries

C K van der Sluis1, D S Kucey, F D Brenneman

  • 1Department of Surgery, Sunnybrook Health Science Centre, Toronto, Ont.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|August 1, 1997
PubMed
Summary

Multisystem trauma patients with upper limb arterial injuries often experience long-term disability due to associated injuries, not the vascular damage itself. Persistent nerve deficits, joint contractures, and pain significantly impair function.

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Area of Science:

  • Trauma Surgery
  • Vascular Surgery
  • Orthopedic Surgery

Background:

  • Multisystem trauma frequently involves arterial injuries to the upper limbs.
  • Assessing long-term outcomes is crucial for managing these complex cases.

Purpose of the Study:

  • To evaluate the long-term functional outcomes for patients with multisystem trauma and upper limb arterial injuries.

Main Methods:

  • Retrospective case series of severely injured patients (ISS > 15) with upper limb arterial injury.
  • Data collected from trauma registry and hospital records (1986-1995).
  • Outcomes assessed included mortality, discharge disposition, disability, and Glasgow Outcome Scale.

Main Results:

  • 25 patients (0.6%) had upper extremity arterial injuries; 24% mortality rate.

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  • High rates of residual disability (69%) including joint contractures, pain, and neural deficits.
  • Only 21% of survivors had minor or no disabilities; associated injuries significantly impacted outcomes.

    • Conclusions:

    • Associated injuries, not the primary vascular damage, are the main cause of long-term disability.
    • Persistent neural deficits, joint contractures, and pain are key factors in functional impairment.