Document Detail


Management of small artery vascular trauma.
MedLine Citation:
PMID:  1415936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This 11-year retrospective study reviewed 99 arterial injuries distal to the brachial bifurcation or popliteal trifurcation in 89 extremities in 88 patients. Associated injuries occurred in 78 of 88 (89%) patients, including 10 fractures or dislocations, 66 nerve injuries, and 59 single or multiple tendon injuries. Fasciotomy was performed in 9 upper extremities and 11 lower extremities (23% of patients). The selection of operative treatment by arterial repair or ligation was by surgeon choice (52% repair and 48% ligation). Postoperative patency was found in 45 of 47 (96%) repaired arteries. In cases of isolated single arterial injuries (10), there were excellent results, and there was no difference in the results between repair and ligation. In cases of nonisolated single arterial injuries (69), there were 46% and 36% nonvascular complications in the repaired and ligated groups, respectively. In 10 patients with nonisolated multiple arterial injuries in the same extremity, the results of repair of one artery with ligation of the other artery versus repair of both arteries were identical, and there were no vascular complications. Operative exploration was the key to complete evaluation of vascular and neuro/musculoskeletal injuries. The data suggest that one functional artery distal to the elbow or knee is sufficient for limb viability and vascular function (follow-up range: 0 to 110 months; mean: 12 months). Nerve injury was the single most important factor of extremity injury in terms of the degree of functional loss.
Authors:
J L Ballard; T J Bunt; J M Malone
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  164     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-10-29     Completed Date:  1992-10-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  316-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Maricopa Medical Center, Phoenix, Arizona 85010.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anastomosis, Surgical
Child
Female
Follow-Up Studies
Humans
Ligation
Male
Microsurgery
Middle Aged
Multiple Trauma / surgery
Paresthesia / etiology
Postoperative Complications
Radial Artery / injuries*,  surgery*
Retrospective Studies
Tibial Arteries / injuries*,  surgery*
Ulnar Artery / injuries*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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