Civilian traumatic vascular injuries of the upper extremity:report of the Iranian national trauma project

Ann Thorac Cardiovasc Surg. 2009 Dec;15(6):389-93.

Abstract

Purpose: The determination of the pattern of traumatic vascular injuries of the upper extremity in Iran was the aim of this study.

Methods: Data of the Iranian national trauma project were used to identify patients with upper extremity vascular injuries. This project was conducted in 8 major cities from 2000-2004.

Results: A total of 113 cases with 130 vascular injuries were found, including 2 axillary, 18 brachial, and 69 radial and ulnar arteries. In 91 cases (81%), penetrating trauma was responsible. Associated nerve and/or upper extremity fractures were seen in 20% and 18% of cases, respectively. End-to-end anastomosis, interposition of saphenous graft, and ligation were used for the management of 44%, 28%, and 17%, respectively, of brachial artery injuries. Ulnar and radial artery injuries had been either ligated (n = 36; 52%) or sutured (n = 33; 48%). Median, ulnar, and radial nerve injuries, except for one, had all been sutured primarily. No patients needed fasciotomy. Amputation and mortality resulting from associated injuries occurred in 3 (2.6%) and 5 (4.4%) patients, respectively.

Conclusion: This study revealed that stabbings are the most frequent causes of these injuries in Iran, in spite of the management of patients in level 3 trauma centers; the rate of amputation is acceptable. However, this study does not provide limb functions of the patients.

MeSH terms

  • Amputation, Surgical
  • Anastomosis, Surgical
  • Blood Vessels / injuries*
  • Cross-Sectional Studies
  • Humans
  • Iran / epidemiology
  • Ligation
  • Limb Salvage
  • Radiography
  • Registries
  • Retrospective Studies
  • Saphenous Vein / transplantation
  • Suture Techniques
  • Time Factors
  • Treatment Outcome
  • Upper Extremity / blood supply*
  • Vascular Surgical Procedures* / statistics & numerical data
  • Wounds and Injuries / diagnostic imaging
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / mortality
  • Wounds and Injuries / surgery*
  • Wounds, Stab / surgery