Traumatic arterial injuries of the upper extremity: Determinants of disability

Hardin, William D.; O'Connell, Ruary C.; Adinolfi, Michael F.; Kerstein, Morris D.

doi:10.1016/0002-9610(85)90134-5

Cited by 56 publications

(22 citation statements)

References 11 publications

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“…7 It is still open to debate whether the nerves should be treated primarily or secondarily. 11 During follow-up, complaints of numbness of an extremity were observed in 71.4% of patients although artery and vein damage was only seen in 15.4% of patients. Throughout the follow-up period we observed that although enough blood flow is provided, problems related to loss of the capacity 33.5±10.8 months.…”

Section: Methodsmentioning

confidence: 94%

“…9 There are also some authors who support the idea that vascular systems should be treated first, to shorten the duration of ischemia. 10,11 Our opinion is that if orthopedic intervention is conducted after vascular systems have been treated, the reconstructed vascular system may be jeopardized. to work and inability to use the extremity persist as long as nerve injury remains.…”

Section: Discussionmentioning

confidence: 99%

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Brachial index does not reflect upper extremity functionality following surgery for vascular trauma

et al. 2014

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Objectives: Vascular injuries to the upper extremities requiring surgical repair are common after accidents. However, neither postoperative functionality nor hemodynamic status of the extremity are routinely described. We evaluated the postoperative functional and hemodynamic status of patients with vascular traumas in the upper extremities. Methods: 26 patients who suffered penetrating vascular traumas in the upper extremities from November 2008 to December 2011 were retrospectively evaluated. Data on first approach, surgical technique employed and early postoperative outcomes were recorded. Further data on the post-discharge period, including clinical functional status of the arm, Doppler ultrasonography and brachial-brachial index were also evaluated. Results: Average follow up was 33.5±10.8 months. Right (1.05±0.09) and left (1.04±0.08) brachial indexes were measured during follow up,. Doppler ultrasonography showed arterial occlusion in 4 patients (15%). Near-normal brachial-brachial indexes was observed in all four of these patients with occlusion of one of the upper extremity arteries, even though they exhibited limited arm function for daily work. Conclusions: Evaluation of the postoperative outcomes of this small series of patients with penetrating vascular traumas in the upper extremity revealed that 15% of them suffered occlusion of one artery of the upper extremity. Artery occlusion did not correlate with brachial-brachial Doppler index, probably due to rich collateral circulation, but occlusion was associated with an extremity that was dysfunctional for the purposes of daily work. The result of the brachial-brachial index does not therefore correlate with functionality.Keywords: arterial injury; trauma; upper extremity; brachial-brachial index; multidisciplinary approach. ResumoObjetivos: Os vasos das extremidades superiores são frequentemente lesados em razão de acidentes. Nós pesquisamos a funcionalidade dos membros superiores com base nos resultados cirúrgicos, além do acompanhamento de lesões de outros órgãos e tecidos. Métodos: Entre novembro de 2008 e dezembro de 2011, 26 pacientes foram encaminhados ao nosso serviço de emergência em razão de lesões vasculares traumáticas da extremidade superior, sendo avaliados retrospectivamente. O atendimento inicial aos pacientes, assim como os diagnósticos e as variedades de tratamento, foram avaliados. Após a alta hospitalar, os pacientes foram acompanhados pelo eco-Doppler e pelo índice tornozelobraço. Resultados: O tempo médio de seguimento foi de 33,5±10,8 meses. Durante o seguimento, os índices braquiais direito (1,05±0,09) e esquerdo (1,04±0,08) foram medidos. Na ultrassonografia Doppler, foi observada obstrução arterial em quatro pacientes. Devido à circulação colateral, o índice tornozelo-braço foi próximo do normal nesses pacientes; entretanto, eles apresentavam limitações funcionais dos membros superiores acometidos, para o trabalho diário. Conclusões: Traumas penetrantes são frequentemente observados em adultos jovens. Esses pacientes d...

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Section: Methodsmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Brachial index does not reflect upper extremity functionality following surgery for vascular trauma

et al. 2014

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“…The three parts (upper [1], middle [2] and lower third [3]) are indicated by the double arrows. The division of the artery into the radial and ulnar branches occurs beneath the bicipital aponeurosis.…”

Section: Surgical Findings and Managementmentioning

confidence: 99%

“…Most likely due to this superficial location, brachial artery injuries are reported to be the most common vascular injury in the upper limb [2][3][4][5][6][7][8][9] and there exist numerous reports that delayed or technically inadequate repair may lead to muscle ischaemia or loss of the limb [2,5,8,10].…”

Section: Introductionmentioning

confidence: 99%

Brachial Artery Injuries: A Seven-year Experience with a Prospective Database

Hardcastle

Johnson

2007

Eur J Trauma Emerg Surg

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Brachial artery injuries are the commonest vascular injuries to the limbs, with a good prognosis, provided early repair is undertaken. Arteriography is usually unnecessary and limb loss is low, provided appropriate decompression of a compartment syndrome is performed, however in this group the limb loss rate is 25% compared to the overall of 2%. The repair of a brachial artery is a good training procedure for surgical trainees, associated with a low morbidity.

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“…[1] [12] Although the signs of acute arterial injury may be masked by extensive collateral circulation in the elbow, but all the brachial artery injuries should be repaired.…”

mentioning

confidence: 99%