title: Clinical outcome and quality of life after upper extremity arterial trauma.
abstract: We assessed the long-term clinical outcome of 33 patients treated for arterial trauma of the upper extremity at the Regensburg University Medical Center between 1996 and 2004. Along with clinical parameters, the Disabilities of Arm, Shoulder, and Hand (DASH) score and the Short Form-36 Health Survey (SF-36) score of each patient were collected at the time of follow-up. Findings of the clinical assessment were compared to results obtained with the DASH score and the SF-36 questionnaire. The median follow-up time was 42 months. All arterial injuries had been reconstructed and were open at the time of follow-up. The prevalence of concomitant neural and/or orthopedic injuries was high (24/33, 72%). The influence of neural injury was by far greater than the impact of other factors on the long-term functional outcome. Furthermore, blunt trauma and the need for immediate fasciotomy were further markers for deficient functional recovery. Both the DASH and the SF-36 scores correlated with the clinical assessment of the severity of functional deficits. Upper extremity vascular trauma is almost always associated with severe concomitant orthopedic and/or neural injuries. The involvement of the brachial plexus and the peripheral nerves of the upper extremity is a predictor of worse long-term functional outcome.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Regensburg Medical Center, University of Regensburg, Regensburg, Germany. itoepel@web.de
authors.forename: Ingolf
authors.initials: I
authors.lastname: Töpel
authors.forename: Karin
authors.initials: K
authors.lastname: Pfister
authors.forename: Andrea
authors.initials: A
authors.lastname: Moser
authors.forename: Alexander
authors.initials: A
authors.lastname: Stehr
authors.forename: Markus
authors.initials: M
authors.lastname: Steinbauer
authors.forename: Lukas
authors.initials: L
authors.lastname: Prantl
authors.forename: Michael
authors.initials: M
authors.lastname: Nerlich
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Schlitt
authors.forename: Piotr M
authors.initials: PM
authors.lastname: Kasprzak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000293:injuries / Q000601:surgery; D001842:Bone and Bones / Q000293:injuries / Q000601:surgery; D002648:Child; D004185:Disability Evaluation; D000071938:Fasciotomy; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D019637:Orthopedic Procedures; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D020196:Trauma, Nervous System / Q000601:surgery; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014656:Vascular Surgical Procedures; D014947:Wounds and Injuries / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D055815:Young Adult