A proposed new system of coding and injury classification for arteries in the trunk and extremities

Chen, Wei; Su, Yanling; Zhou, Qi Tony; Zhang, Yingze; Smith, Wade R.; Ma, Lijie; Guo, Mingke; Zheng, Zuduo; Qin, Di; Liu, Jianning

doi:10.1016/j.injury.2010.09.005

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…[5,[13][14][15] However, clinical experience and the skills of the surgeon are more critical than the scoring systems in the upper extremity crush injuries. [6,8,[15][16][17][18] This is probably the result of several contributing factors. [8,[18][19][20] Due to the complexity of the artery injury and the limitations of the imaging studies, it is still difficult to reveal all lesions of the interested arteries in certain cases.…”

Section: Discussionmentioning

confidence: 99%

Histopathological evaluation of the arterial wall damage in upper limb injuries

Özçınar¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada, üst ekstremite ezilme yaralanmaları arter duvarındaki histopatolojik değişikliklere göre değerlendirildi ve erken ve geç dönem klinik sonuçlar bildirildi.Ça lış ma pla nı: Şubat 2011 -Kasım 2013 tarihleri arasında üst ekstremite ezilme yaralanması olan 12 hastanın (9 erkek, 3 kadın; ort. yaş 33.3±11.7 yıl; dağılım 18-57 yıl) prospektif olarak toplanan verileri retrospektif olarak incelendi. Hastaların tümünün Ezilmiş Ekstremite Şiddet Skoru ≥7 idi ve tümünde ciddi vasküler yaralanma bulguları vardı. Ortopedik stabilizasyon sonrasında vasküler rekonstrüksiyon yapıldı. Hemodinamik stabilizasyon sonrasında, rutin olarak dijital substraksiyon anjiyografi çekildi. Revaskülarizasyon işlemi sırasında, hasarlı arter damarları çıkarıldı ve formalin solüsyonunda saklandı. Endotelyal şişme, intimal kalınlaşma, kas tabakasındaki hücresel vaküolizasyon, tunika medyadaki ödem ve nekrozun derecesi değerlendirildi.Bul gu lar: Yaralanma beş hastada işe bağlı kazalar ve yedi hastada motorlu araç kazaları ile ilişkiliydi. Tüm hastalara ven greft interpozisyonu uygulandı (12; %100). Primer açıklık oranı %75 idi ve bir hasta kaybedildi (30 günlük mortalite %8.3). On iki hastada üç amputasyon yapıldı. Medyan takip süresi 3.2 (dağılım: 2.1-3.7) yıl idi. Alınan örneklerin mikroskopik incelemesinde vasküler konjesyon ve trombüs oluşumu, ilerleyici subintimal diseksiyon ve elastik internanın membranında yırtılma olduğu belirlendi.So nuç: Çalışma sonuçlarımız Ezilmiş Ekstremite Şiddet Skoruna göre amputasyon endikasyonu olsa da, ekstremite kurtarma işlemlerinin uygulanmasını önermektedir.Anah tar söz cük ler: Ezilme yaralanması; patolojik değerlendirme; üst ekstremite revaskülarizasyonu. ABSTRACTBackground: This study aims to evaluate the upper limb crush injuries according to the histopathological changes in the arterial vessel and to report the early and late clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Histopathological evaluation of the arterial wall damage in upper limb injuries

Özçınar¹

2017

Turk Gogus Kalp Dama

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“…A� mechanism �as defined as penetrating or non�penetrating. AT type was described using the clas� sification as s�ggested b� �hen et al 10 According to their classification three major �essel inj�r� t�pes �ere o�tlined: �itho�t disr�ption, �ith partial disr�ption and �ith com� plete disr�ption. Inj�r� topograph� incl�ded head, neck, arm, chest, abdomen or leg.…”

Section: Methodsmentioning

confidence: 99%

Age differences of arterial trauma – Selection of the most appropriate age classification

Petrov

2020

Pol. Ann. Med.

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Introduction: Studies on age differences of arterial trauma (AT) carry significant methodological differences in terms of selection of the most appropriate age classification. Aim: This study aims to verify the most optimal age classification when comparing clinical patterns of the civil AT. Material and methods: 222 AT patients were identified from the Lviv Clinical Regional Hospital. In each case the following clinical patterns were identified: patient age, etiology, mechanism, AT type, topography, diagnostics mode, treatment type. Patients were distributed using six age classifications (Erikson 1950, UN 1989, Quinn 1994, Craig 2000, WHO physical activity recommendations 2010, by decades of life). Generalized linear models (GLMs) were created, with age distributions as predictors and clinical patterns as dependent factors. Akaike information criterion (AIK) was used to compare the quality of statistical sets. Results and discussion: Six GLMs were obtained, in each age of them age classifications were compared using the AIK. Rating list of age classifications was developed (starting with the most appropriate and ending with the least appropriate): E. Erikson (1950) → V. Quinn (1994) → G. Craig (2000) → UN (1989) → Decades → WHO (2010). Conclusions: Human development classifications may be preferable in assessing the age differences of AT in patients of wide range.

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“…Zhang YZ. put forward the concept of "occult vascular injury" as early as 2011, which is a kind of injury with atypical clinical symptoms that can easily delay diagnosis and miss the best time for treatment [14,15] . In our classi cation, there are three types that are more di cult to diagnose, which are considered as "occult vascular injury".…”

Section: General Informationmentioning

confidence: 99%

A new classification of femoral shaft fracture combined with femoral artery injury

Chi

et al. 2020

Preprint

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Background:To explore a new classification of femoral shaft fracture combined with femoral artery injury and to summarize and analyse the characteristics of various types of injury to formulate a correct early diagnosis and treatment strategy.Methods: The data of 21 patients with femoral shaft fracture combined with femoral vascular injury from December 2009 to March 2019 were analysed retrospectively, including 20 males and 1 female aged (40 ±15.5) years. The causes of injury were traffic injury (n = 16), heavy object injury (n = 3), fall injury (n = 1), crush injury (n = 1), open fracture (n = 12) and closed fracture (n = 9). The patients were classified according to whether the femoral shaft fracture was open, the location of femoral artery injury and whether it was combined with a severe multiple injury. The open femoral shaft fracture with femoral artery injury was type I, in which a similar location of fracture and vascular injury comprised type Ia, while different locations comprised type Ib. The closed femoral shaft fracture with femoral artery injury was type II, in which fracture and vascular injury at same level comprised type IIa and different levels comprised type IIb. Patients with severe multiple injuries had a type III fracture. The location of femoral shaft fracture, femoral artery injury and injury; main signs; diagnosis time; waiting time before operation; operation time; times of operations; hospitalization time; and Enneking lower limb function score were recorded.Results: According to our classification, there were 7 cases of type Ia, 4 cases of type Ib, 6 cases of type IIa, 3 cases of type IIb and 1 case of type III. The location of femoral fracture (lower segment in 7 cases, middle segment in 9 cases, proximal segment in 5 cases) and feoral artery injury (adductor tendon fissure in 12 cases, superior popliteal fossa in 7 cases, proximal deep femoral artery bifurcation in 2 cases) and the type of femoral artery injury (contusion and embolization in 3 cases, complete rupture in 18 cases) were compared. The diagnosis time for type I patients were 2.0 (1.0, 2.0) h, the preoperative waiting time was 3.5 (3.0, 5.0) h, the first operation time was 405.0 (335.0, 540.0) min, the number of operations was 2.0 (2.0, 4.0) times, the length of hospital stay was 49.0 (21.0, 71.0) days, the fracture healing time was 7.0 (5.0, 9.0) months, and the Enneking lower extremity function score was 20.0 (19.0, 22.0) points. The diagnosis time for type II patients was 7.0 (6.0, 18.5) h, the waiting time before surgery was 9.0 (8.3,20.5) hours, the first operation time was 385.0 (319.5, 490.0) min, the number of operations was 3.0 (2.0, 3.5) times, the length of hospital stay was 57.0 (29.0, 111.5) days, the fracture healing time was 6.00 (5.50, 7.50) months, and the Enneking lower limb function score was 14.0 (13.0, 15.5) points. All patients had signs of obvious weakening or disappearance of dorsal pedis artery pulsation, all type II patients had blue ecchymosis signs at the site of vascular injury, 6 patients had normal muscle strength and sensation of lower limbs, 12 patients had dorsal extension dysfunction, and 1 patient underwent thigh amputation.Conclusion: The new classification of femoral shaft combined with femoral artery injury is helpful in the diagnosis, treatment and prognosis of the injury. Generally speaking, the diagnosis time of type I injury is faster than that of type II injury, the waiting time before operation is shorter, and the prognosis of lower limb function is better. Sufficient attention should be paid to the type II injury.Weakening or disappearance of dorsal pedis artery pulsation and blue ecchymosis signs are typical signs .

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A proposed new system of coding and injury classification for arteries in the trunk and extremities

Cited by 6 publications

References 21 publications

Histopathological evaluation of the arterial wall damage in upper limb injuries

Histopathological evaluation of the arterial wall damage in upper limb injuries

Age differences of arterial trauma – Selection of the most appropriate age classification

A new classification of femoral shaft fracture combined with femoral artery injury

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