Handlebar injury to femoral vein: case report and review

Hassouna, A.; Dennis, Michael

doi:10.1258/phleb.2010.010050

Cited by 6 publications

(4 citation statements)

References 4 publications

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“…Case reports of extremity vascular injuries exist; but within our cohort, vascular injury represents 3.7% of handlebar injuries and should be considered in any patient with the concern of a handlebar injury to the extremity. [14][15][16] Soft tissue injuries were more frequent in patients with handlebar injuries, but the incidence of requiring intervention was no different across groups. Within the handlebar group, 4 patients had an abdominal wall hernia.…”

Section: Discussionmentioning

confidence: 97%

“…All of the nonhandlebar injuries were fractures, many of which were treated operatively the day after admission, whereas the handlebar injuries included 4 vascular injuries, which were taken emergently/urgently for surgical repair. Case reports of extremity vascular injuries exist; but within our cohort, vascular injury represents 3.7% of handlebar injuries and should be considered in any patient with the concern of a handlebar injury to the extremity 14–16 …”

Section: Discussionmentioning

confidence: 99%

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Pediatric Handlebar Injuries

et al. 2019

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Objectives: Injuries associated with bicycles can generally be categorized into 2 types: injuries from falling from/off bicycles and injuries from striking the bicycle. In the second mechanism category, most occur as a result of children striking their body against the bicycle handlebar. The purpose of this study was to evaluate the presentation, body location, injury severity, and need for intervention for pediatric handlebar injuries at a single level one pediatric trauma center and contrast these against other bicycle-related injuries in children. Methods:This work is a retrospective review of the trauma registry over an 8-year period. Individual charts were then reviewed for patients' demographic factors, injury details, and other clinical/radiographic findings. Each patient was then categorized as either having a handlebar versus nonhandlebar injury. Additionally, each patient's injuries were classified according to affected body "zone(s)" and the need for intervention in relation to these injuries. During the course of chart review, several unique radiographic and history/physical findings were noted and are also reported.Results: During the study period, 385 patients were identified that met study criteria. Bicycle handlebars were involved in 27.8% (107/385) of injuries and 72.2% (278/385) were nonhandlebar injuries. There were differences in injury severity score, Head Abbreviated Injury Scale, length of stay between patients with handlebar versus nonhandlebar injuries, respectively. There were also differences in incidence of injuries across most body zones between patients with handlebar versus nonhandlebar injuries. There was statistically significant difference in need for intervention for abdominal solid organ injuries among handlebar versus nonhandlebar injuries mechanisms (21.6% vs 0%; P = 0.026), respectively. Sixteen patients with a handlebar injury underwent abdominal computed tomography (CT), which found only pericolic/pelvic free fluid or were negative for any disease and had normal/mildly elevated liver function test results at the time of arrival with otherwise normal laboratory workup results. Two patients required laparotomy for bowel injury and presented with peritonitis less than 12 hours after injury. The remaining patients did not have peritonitis on examination and were discharged without operative intervention 12 to 24 hours after injury without further event. Conclusions:The bicycle handlebar is a unique mechanism of injury.The location, need for intervention, and the nature of the injury can vary significantly compared to other bicycle injuries. Handlebar injuries are more likely to cause abdominal and soft tissue injuries, whereas nonhandlebar injuries are more likely to cause extremity and skull/neck/central nervous system injuries. Because more than 20% of the reported handlebar injuries did not involve the abdomen or thoracoabdominal/extremity soft tissue as well as the variable presentation of handlebar injuries, it is imperative for the physician to consider this mechanism in...

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Pediatric Handlebar Injuries

et al. 2019

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“…While rare in occurrence, most vascular traumas associated with this mechanism of injury involve the common femoral artery (CFA) or external iliac artery (EIA) 9. To our knowledge, venous trauma stemming from handlebar trauma has only been reported three times,10–12 and this is the first case report to feature a patient experiencing complete destruction to both the CFA and the CFV due to handlebar trauma. This is an uncommon mechanism of injury and is frequently missed on the initial presentation,9 with potentially catastrophic injuries if unattended.…”

Section: Introductionmentioning

confidence: 90%

Comparison of two bicycle handlebar trauma cases

Atkinson,

Rajagopalan

2024

BMJ Case Rep

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Handlebar injury is an uncommon mechanism of blunt injury with a recognised risk of injury to groin vasculature. We describe two cases involving bicycle handlebar injury to the groin and their different respective outcomes. Patient A sustained a significant limb-threatening injury following significant arterial and venous disruption. Surgical intervention was able to restore arterial flow via interpositional vein graft, while venous injuries were ligated. As a result, the patient was discharged with a viable limb and a non-disabling swelling from venous pathology. Patient B, of identical age, also sustained a bicycle handlebar injury to the groin but without the need for surgical intervention. Active observation and the use of repeat imaging suggested spontaneous cessation of any minor arterial bleeding; the patient made a rapid recovery and was discharged soon thereafter. These cases highlight the variability in outcome stemming from this injury mechanism and that early recognition is vital for limb viability.

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“…But Yelon et al reported that 86% of patients treated by ligation of pelvic or lower extremity venous injuries were free of oedema at discharge 3 . Thrombosis and failure of repair can occur in up to 15% patency rate up to 74% following repair 4 . For optimal long-term patency and to minimize chronic complications a durable venous repair is needed.…”

Section: Dear Editormentioning

confidence: 99%