Management of Arterial Injuries

Acute Penetrating Arterial Injuries of the Neck and Limbs

“…Depending on the judgment made on the grounds of this combined clinical evidence, the surgeon may (1) rule out the presence of an arterial injury, (2) decide to explore the artery angiographically to determine whether an arte¬ rial injury is present, or (3) proceed directly to the repair of an arterial injury that he feels certain is present. Ta¬ ble 2 summarizes our experience with these various ap¬ proaches to the establishment of the diagnosis of arterial injury.…”

Vascular Injuries Associated With Fractures of the Femur

“…The experience gained during the Vietnam war in treating such injuries without internal fixation5·6 has led to reassessment of treatment in civilian practice.7 Several recent articles deal specifically with this problem and sup¬ port the idea of external stabilization of fractures when an associated vascular injury is present.8 9 Experimental data support the safety of the use of skeletal traction for fracture immobilization when vascular repair has been performed.10 The present study was done to evaluate the use of internal and external immobilization in treating fractures of the femur associated with vascular injury.…”

Microsurgical reconstruction of brachial artery injuries in displaced supracondylar fracture humerus in children

“…1,18 Many surgeons are reluctant to explore a supracondylar fracture with neurovascular deficit because the limb is usually not threatened, 6,17,19 while others recommend brachial artery exploration in cases of white pale hand, 20 but it is clear that a significant arterial injury may exist without a detectable change in distal pulse or evidence of ischemia. 21 In this series the main indication for exploration of the brachial artery was absent radial pulse either after closed reduction and percutaneous pinning or in cases with high risk of brachial artery injury as in open fractures, brachialis muscle tethering, and sever elbow swelling. In this series 120 cases had impalpable radial pulse following displaced supracondylar fractures, 89 cases regained palpable radial pulse after closed reduction and percutaneous pinning, and 31 cases had brachial artery injury on exploration (i.e.…”