Upper extremity vascular injuries:Etiology,management and outcome

作     者：Nikolaos Stefanou Theodoros Mylonas Fragkiskos A Angelis Christina Arnaoutoglou Sokratis E Varitimidis Zoe H Dailiana 

作者机构：Department of Orthopaedic SurgeryFaculty of MedicineSchool of Health SciencesUniversity of ThessalyUniversity Hospital of LarissaLarissa 41500Greece Department of HandUpper Extremity and MicrosurgeryIASO ThessaliasLarissa 41500Greece 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2024年第13卷第2期

页      面：159-167页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Upper extremity Vascular injuries Complex injuries Musculoskeletal trauma Mangled extremity 

摘      要：BACKGROUND Vascular injuries of the upper extremities are considered relatively rare injuries affecting mostly the young *** often are complex injuries accompanied by other musculoskeletal trauma or trauma in other anatomic *** management is challenging since they can lead to disabilities with major socioeconomic *** To analyze data about the mechanism of injury,the management algorithm and functional outcomes of vascular injuries of the upper *** One hundred and fifteen patients(96 males and 19 females)with arterial injuries of the upper extremity treated in a tertiary trauma center from January 2003 to December 2022 was *** patients’age was 33.7 years and the mean follow up time was 7.4 *** with Mangled Extremity Severity Score≥7 and Injury Severity Score≥20,previous upper limb surgery or major trauma and any neuromuscular or psychiatric disease were excluded,from the *** A penetrating trauma was the most common cause of *** radial artery was the artery injured in most of the cases(37.4%)followed by the ulnar(29.5%),the brachial(12.1%)and the axillary(6%).A simultaneous injury of both of the forearm’s arteries was in 15.6%of the *** 93%of the cases there were other concomitant musculoskeletal injuries of the *** lacerations were the most common,followed by nerve *** postoperative functional scores(full Disabilities of the Arm,Shoulder,and Hand and VAS)had very satisfactory *** Although vascular injuries of the upper extremity are rare,they may occur in the context of major combined musculoskeletal *** a multidisciplinary approach is essential to optimize outcome,the ability of trained hand surgeons to repair all injuries in combined vascular and musculoskeletal upper extremity trauma,excluding isolated vascular injuries,ensures shorter operative times and better functional outcomes.