Isolated Pediatric Peripheral Vascular Injury Caused by Blunt Trauma: A New Occurrence

Hoover, J.; Almond, P. S.

doi:10.1097/01.ta.0000066521.99659.a6

Cited by 6 publications

(4 citation statements)

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“…Furthermore, to support appropriate limb growth, the repair of vascular injuries in pediatric patients needs more than just flow-preserving patency. [3][4][5][6][7] Most vascular injuries can be managed by repair with end-to-end primary anastomosis, although an extensive and widespread injury may demand the use of graft interposition. The proper conduit is the natural one, using the great saphenous vein.…”

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confidence: 99%

Reliability of the Mangled Extremity Severity Score in the Management of Peripheral Vascular Injuries in Children: A Retrospective Review

et al. 2020

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This study was aimed to evaluate different management modalities for peripheral vascular trauma in children, with the aid of the Mangled Extremity Severity Score (MESS). A single-center retrospective analysis took place between 2010 and 2017 at University Hospitals, having emergencies and critical care centers. Different types of vascular repair were adopted by skillful vascular experts and highly trained pediatric surgeons. Patients were divided into three different age groups. Group I included those children between 5 and 10 years; group II involved pediatrics between 11 and 15 years; while children between 16 and 21 years participated in group III. We recruited 183 children with peripheral vascular injuries. They were 87% males and 13% females, with the mean age of 14.72 ± 04. Arteriorrhaphy was performed in 32%; end-to-end anastomosis and natural vein graft were adopted in 40.5 and 49%, respectively. On the other hand, 10.5% underwent bypass surgery. The age groups I and II are highly susceptible to penetrating trauma (p = 0.001), while patients with an extreme age (i.e., group III) are more susceptible to blunt injury (p = 0.001). The MESS has a significant correlation to both age groups I and II (p = 0.001). Vein patch angioplasty and end-to-end primary repair should be adopted as the main treatment options for the repair of extremity vascular injuries in children. Moreover, other treatment modalities, such as repair with autologous vein graft/bypass surgery, may be adopted whenever possible. They are cost-effective, reliable, and simple techniques with fewer postoperative complication, especially in poor/limited resources.

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confidence: 99%

Reliability of the Mangled Extremity Severity Score in the Management of Peripheral Vascular Injuries in Children: A Retrospective Review

et al. 2020

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“…There were two published cases that resulted in complete transection of the superficial femoral artery (SFA) and vein (SFV). 3,4 One was a high-energy mechanism, unlike ours, where a pedestrian was struck just above the knee by a car, resulting in transection of both the SFV and SFA at the level of the Hunter canal. 3 The other involved transection of both the SFV and SFA when a heavy object fell on the patient's groin.…”

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confidence: 95%

“…3,4 One was a high-energy mechanism, unlike ours, where a pedestrian was struck just above the knee by a car, resulting in transection of both the SFV and SFA at the level of the Hunter canal. 3 The other involved transection of both the SFV and SFA when a heavy object fell on the patient's groin. 4 Unlike these two cases, our case involved no extrinsic blow to the limb and our injury was proximal, involving the common femoral vessels.…”

Section: Discussionmentioning

confidence: 95%

“…The occurrence of an isolated femoral vessel injury in the absence of bony fractures or polytrauma is extremely rare, as signified by scattered case reports in the literature (Table I). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] We describe an unusual case with late presentation of a blunt hyperextension mechanism leading to complete avulsion of the femoral vessels.…”

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confidence: 99%

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