title: Outcomes of digital artery revascularization in pediatric trauma.
abstract: BACKGROUND
  Digit amputation is rare in pediatric trauma but can lead to functional morbidity. The true incidence of digital arterial injury is lacking in the literature, and revascularization techniques are not well-described.
  
  
  METHODS
  Retrospective review of a pediatric trauma registry identified patients with a digital artery injury between July 2008 and December 2013. Isolated vein injuries and arterial injuries proximal to the digits were excluded. Descriptive statistics were used.
  
  
  RESULTS
  Twenty-five subjects met inclusion. Most were male (n=16; 64%) and the median age was 6.8 (IQR: 2.8, 11.1) years. The most common blunt (n=12) trauma was struck/crushed by object (n=4; 33%) and the most common penetrating (n=13) trauma was because of glass (n=9; 69%). All subjects were managed operatively. Initial operations for arterial repair were primary arterial repair (15; 20%), vein graft (7; 28%), thrombectomy (1; 4%), and amputation (1; 4%). Twelve patients (48%) had reported complications at initial follow-up, but only two (8%) had long-term (>24weeks) sequelae.
  
  
  CONCLUSIONS
  Digital artery injury is rare among pediatric traumas. Functional outcomes after digital artery revascularization are favorable. Primary repair can successfully manage these injuries and vein grafting appears to be a suitable alternative when primary repair is not feasible.
authors.affiliation: Department of Surgery and Level I Pediatric Trauma Center, Phoenix Children's Hospital, 1919 E Thomas Ave, Phoenix, AZ, USA, 85016; Department of Surgery, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, USA, 85054.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Linnaus
authors.affiliation: Department of Surgery and Level I Pediatric Trauma Center, Phoenix Children's Hospital, 1919 E Thomas Ave, Phoenix, AZ, USA, 85016.
authors.forename: Crystal S
authors.initials: CS
authors.lastname: Langlais
authors.affiliation: Department of Pediatric Emergency Medicine, Phoenix Children's Hospital, 1919 E Thomas Ave, Phoenix, AZ, USA, 85016.
authors.forename: Mary
authors.initials: M
authors.lastname: Kirkilas
authors.affiliation: Department of Pediatric Emergency Medicine, Phoenix Children's Hospital, 1919 E Thomas Ave, Phoenix, AZ, USA, 85016; Department of Child Health, University of Arizona College of Medicine - Phoenix, 550 E Van Buren St, Phoenix, AZ, USA, 85004.
authors.forename: Jared T
authors.initials: JT
authors.lastname: Muenzer
authors.affiliation: Arizona Center for Hand Surgery, 370 E Virginia Ave, Suite 100, Phoenix, AZ, USA, 85004.
authors.forename: Jozef
authors.initials: J
authors.lastname: Zoldos
authors.affiliation: Department of Surgery and Level I Pediatric Trauma Center, Phoenix Children's Hospital, 1919 E Thomas Ave, Phoenix, AZ, USA, 85016; Department of Child Health, University of Arizona College of Medicine - Phoenix, 550 E Van Buren St, Phoenix, AZ, USA, 85004.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Graziano
authors.affiliation: Department of Surgery and Level I Pediatric Trauma Center, Phoenix Children's Hospital, 1919 E Thomas Ave, Phoenix, AZ, USA, 85016; Department of Child Health, University of Arizona College of Medicine - Phoenix, 550 E Van Buren St, Phoenix, AZ, USA, 85004; Department of Surgery, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, USA, 85054. Electronic address: dnotrica@phoenixchildrens.com.
authors.forename: David M
authors.initials: DM
authors.lastname: Notrica
mesh_terms: D000293:Adolescent; D000671:Amputation, Surgical; D001158:Arteries / Q000293:injuries* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000098:blood supply* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods; D057772:Vascular System Injuries / Q000601:surgery*
keywords: Arterial repair; Digital artery; Outcomes; Pediatric