Vascular injuries of the upper arm.
Twenty eight patients who had subclavian, axillary, and brachial artery injuries were studied. Sixteen (57%) sustained blunt trauma and 12 (43%) sustained penetrating trauma. Motor cycle accidents were the most common cause of injuries (43%). Twenty patients (71.4%) were transferred from other hospitals. Nine patients (32%) were in shock on arrival. All patients had radial pulse abnormalities (3 decreased, 25 absent) of the affected limbs. Eighteen patients (64%) had associated injuries to other parts of the body. Eighteen patients (64%) also had associated nerve injuries, 7 of them had complete brachial plexus injuries from motor cycle accidents. Twelve patients (43%) had preoperative angiography. Twelve patients (43%) had brachial, 10 (35.7%) had axillary, 2 (7%) had axillary-subclavian, and 4 (14%) had subclavian artery injuries. Eight patients (28.6%) had concomitant venous injuries. Resection of the injured artery and reversed saphenous vein graft were performed in 23 patients (82%). The remaining had resection and end to end anastomosis in 3 patients (10.7%), lateral repair in 2 patients (7%), and ligation in 1 patient (3.6%). Concomitant venous repairs were performed in 5 patients. Fasciotomies were performed in 2 patients (7%). Excellent results of vascular repairs were obtained in all patients. Long-term disability occurred in patients who had associated nerve injuries. Avulsion injury of the brachial plexus usually resulted in severe impairment of limb function.
Sriussadaporn
S
S
Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
D000293:Adolescent; D000328:Adult; D001132:Arm / Q000098:blood supply* / Q000294:innervation; D001134:Arm Injuries / Q000209:etiology / Q000601:surgery*; D001158:Arteries / Q000293:injuries / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014680:Veins / Q000293:injuries / Q000601:surgery