title: Gradually increasing predominance of self-mutilation in upper extremity arterial injuries: less morbidity but with high threat to society.
abstract: BACKGROUND
  Although vascular trauma of the upper extremity is increasingly more common, mortality and morbidity rates remain low, at between 0-8%. Self-mutilation has become evident in recent years. We planned this study to compare the results of self-mutilation with other penetrating trauma in upper extremity vascular injuries and also to emphasize the dangers of self-mutilation for society.
  
  
  METHODS
  Data of 249 patients with penetrating vascular injury of the upper extremity were retrospectively analyzed. There were 214 male (86%) and 35 female (14%) patients, with a mean age of 24.76 ± 11.28 years (range: 2-69 years). Of these, 129 (52%) were self-mutilators.
  
  
  RESULTS
  The ulnar artery was the most frequently affected (n=140, 56%). There was no mortality or limb loss. However, eight (3.21%) patients, who had penetrating trauma, had restriction in finger motions. Male predominance, substance abuse and associated nerve injury were significantly more common among self-mutilators (p values <0.001, <0.001 and 0.005, respectively), whereas brachial artery injury, vein graft interposition and fasciotomy rates were higher among the penetrating trauma group (p<0.001 for all).
  
  
  CONCLUSIONS
  The form of and reason for injuries and presence of substance abuse in case of self-mutilation must be investigated cautiously, and the immediate commencement of psychiatric treatment must be provided to the self-mutilators.
authors.affiliation: Department of Cardiovascular Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey. aendertopal61@hotmail.com
authors.forename: Aşkın Ender
authors.initials: AE
authors.lastname: Topal
authors.forename: Mehmet Nesimi
authors.initials: MN
authors.lastname: Eren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000150:complications*; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D005260:Female; D005383:Finger Injuries / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology; D012652:Self Mutilation / Q000209:etiology*; D014457:Ulna / Q000293:injuries; D057772:Vascular System Injuries / Q000150:complications*; D014950:Wounds, Penetrating / Q000150:complications*