Trauma to arteries of the forearm

Abstract

Trauma to arteries of the forearm corresponds to 20% of total arterial trauma. The authors analyzed 24 patients with non iatrogenic trauma of the forearm arteries, cared for from January 1987 to December 1990. All patients were male, trauma by penetrating instrument was the most frequent, with 21 cases (87.5%), absence of pulses was the most frequent clinical manifestation (62.5%), fifteen patients did not present ischemic manifestations (54.2%) and half of the patients did not exhibit neurological symptoms. Injury to only one artery was found in 11 cases, five of them in the radial artery (20.8%), five in the ulnar artery (20.8%) and one in the interosseous artery (4.2%). Concurrent injury to the radial and ulnar arteries was found in 13 cases (54.1%). Regarding nervous impairment, injury to the radial nerve was found in four cases (16.6%) and of the median and ulnar nerves, one case in each (4.1%). All patients with concurrent injury to the ulnar and radial arteries (13) were submitted to arterial restoration. The 11 patients with injury to a sole artery of the forearm were managed as follows: ligature of the interosseous artery in one case, ligature of the radial artery in four cases, raphe of the radial artery in one case, ligature of the ulnar artery in three cases, restoration of the ulnar artery using a segment of the v. saphena in the two cases in which the Allen test had been positive. One patient died in the immediate postoperative period as a result of multiple organ failure due to polytraumatism.(ABSTRACT TRUNCATED AT 250 WORDS)

Peripheral Vascular Trauma in Pediatrics: A Case Report and Literature Review

“…These figures vary considerably, and some authors have reported the penetrating mechanism being more frequent than blunt [5]. Penetrating traumas in the upper limb are mostly caused by pieces of broken glass, knives and sharp instruments [4,6,7]. These are considered as complicated lesions and represent a diagnostic and therapeutic challenge due to the anatomical and physiological characteristics of the pediatric age, such as the configuration of the vessels, which tend to be smaller and thin walled [1].…”

“…The diagnosis of peripheral vascular injuries is obtained by a systematic and judicious physical examination. At the forearm level, it may be more evident due to the superficial location of the arteries and the presence of hard signs, such as the absence of a distal pulse, auscultation of a murmur or palpating a thrill, as well as paleness and coldness of the limb (Figure 1) [7,8]. In those cases, Doppler ultrasonography and arteriography are indicated, since these signs are related to a high suspicion of vascular injury.…”

Multiple Digital Gangrene after a Radial Artery Penetrating Injury: A Case Report

“…1 The clinical manifestations of arterial injury may be subtle; in a survey of 66 patients with 69 penetrating forearm arterial injuries, no clinical evidence of vascular injury was found in 9.1% and 42.4% had normal pulses. 2 The most frequent type of arterial injury was transection (72.5%).…”