Acute vascular injury associated with fracture of the distal radius: a report of 6 cases.
OBJECTIVE
To highlight the potential for vascular injury with fracture of the distal radius.


METHODS
Retrospective case series.


METHODS
The practices of several orthopaedic hand surgeons.


METHODS
Six patients with arterial injury as a consequence of fracture of the distal radius: 2 partial lacerations of the radial artery, 2 complete arterial lacerations (1 radial and 1 ulnar), 1 thrombosed radial artery, and 1 thrombosed ulnar artery. There were 4 men and 2 women with an average age of 42 years (range 26-70 years). Three of the fractures were open, and 3 had an associated distal ulnar fracture.


METHODS
Volar open reduction and internal fixation of the distal radius fracture. Ligation or no treatment for 3 arterial injuries and repair or vein graft reconstruction (1 patient) for 3 injuries.


METHODS
Vascular status of the hand.


RESULTS
At an average follow-up of 9 months (range 5-16 months), all patients had a well-vascularized hand, normal capillary refill, and no complaints of vascular dysfunction.


CONCLUSIONS
Vascular complications, once thought rare in association with fracture of the distal radius, may be more frequently recognized as volar exposures are increasingly used. Because most single artery injuries in the wrist and forearm are not associated with ischemia, identification of these injuries is unlikely to affect the functional result or outcome. In the unusual patient with a dysvascular hand after distal radius fracture, arterial reconstruction may be necessary.
de Witte
Pieter Bas
PB
Orthopaedic Hand and Upper Extremity Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
Lozano-Calderon
Santiago
S
Harness
Neil
N
Watchmaker
Greg
G
Green
Michael S
MS
Ring
David
D
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001158:Arteries / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D011885:Radius Fractures / Q000601:surgery*