Limb arterial injuries associated with limb fractures: Clinical presentation, assessment and management
Review of limb arterial injuries associated with limb fractures. Retrospective study. University Hospital. The clinical presentation, assessment and management of 25 patients with upper (seven) and lower (18) limb arterial injuries associated with limb bone fractures has been retrospectively reviewe...
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| Veröffentlicht in: | European journal of vascular and endovascular surgery 1995, Vol.9 (1), p.64-70 |
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| creator | Katsamouris, Asterios N. Steriopoulos, Kostas Katonis, Panos Christou, Kostas Drositis, John Lefaki, Tatiana Vassilakis, Sophocles Dretakis, Emmanuel |
| description | Review of limb arterial injuries associated with limb fractures.
Retrospective study.
University Hospital.
The clinical presentation, assessment and management of 25 patients with upper (seven) and lower (18) limb arterial injuries associated with limb bone fractures has been retrospectively reviewed.
Five patients presented with life threatening injuries and classic signs of acute limb ischaemia, 15 patients had an obvious limb arterial injury, and 5 presented with a suspected limb arterial injury. The site of arterial damage was: superficial femoral (4); popliteal (11); tibioperoneal trunk (3); anterior tibial (4); posterior tibial (3); peroneal (2); axillary (1); brachial (5); radial (4); and ulnar artery (4). The types of arterial repair were: autogenous vein interposition or bypass grafting (17); P.T.F.E. (2); end-to-end anastomosis (14); and ligation (8). The popliteal vein was injured in six cases, repaired in four and ligated in two; the superficial femoral vein was injured in four cases, repaired in three and ligated in one; and the axillary vein was injured in one case and was ligated. Primary nerve repair was employed in six out of seven injured nerves. Skeletal fixation preceded vascular repair in 21 patients and in four a Javid shunt was used. Intraoperative fasciotomy was performed in 12 out of 18 patients with lower limb ischaemia. Completion arteriography revealed residual thrombi in the distal foot of four patients, in whom intraarterial thrombolysis was effective. During the follow-up period of 1.5 to 2 years, the upper and lower limb preservation rate was 100 and 89%, respectively. The upper limb function was judged excellent in five patients, good in one and fair in one. In the lower limbs it was excellent in 11 patients, good in three, fair in one and poor in one.
To ensure life and functional limb salvage of patients with devastating vascular injuries, a well organised multidisciplinary approach is necessary. |
| doi_str_mv | 10.1016/S1078-5884(05)80227-8 |
| format | Article |
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Retrospective study.
University Hospital.
The clinical presentation, assessment and management of 25 patients with upper (seven) and lower (18) limb arterial injuries associated with limb bone fractures has been retrospectively reviewed.
Five patients presented with life threatening injuries and classic signs of acute limb ischaemia, 15 patients had an obvious limb arterial injury, and 5 presented with a suspected limb arterial injury. The site of arterial damage was: superficial femoral (4); popliteal (11); tibioperoneal trunk (3); anterior tibial (4); posterior tibial (3); peroneal (2); axillary (1); brachial (5); radial (4); and ulnar artery (4). The types of arterial repair were: autogenous vein interposition or bypass grafting (17); P.T.F.E. (2); end-to-end anastomosis (14); and ligation (8). The popliteal vein was injured in six cases, repaired in four and ligated in two; the superficial femoral vein was injured in four cases, repaired in three and ligated in one; and the axillary vein was injured in one case and was ligated. Primary nerve repair was employed in six out of seven injured nerves. Skeletal fixation preceded vascular repair in 21 patients and in four a Javid shunt was used. Intraoperative fasciotomy was performed in 12 out of 18 patients with lower limb ischaemia. Completion arteriography revealed residual thrombi in the distal foot of four patients, in whom intraarterial thrombolysis was effective. During the follow-up period of 1.5 to 2 years, the upper and lower limb preservation rate was 100 and 89%, respectively. The upper limb function was judged excellent in five patients, good in one and fair in one. In the lower limbs it was excellent in 11 patients, good in three, fair in one and poor in one.
To ensure life and functional limb salvage of patients with devastating vascular injuries, a well organised multidisciplinary approach is necessary.</description><identifier>ISSN: 1078-5884</identifier><identifier>EISSN: 1532-2165</identifier><identifier>DOI: 10.1016/S1078-5884(05)80227-8</identifier><identifier>PMID: 7664015</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acute ischaemia ; Adult ; Arm Injuries - complications ; Arterial injury ; Arteries - injuries ; Arteriography ; Blood Vessel Prosthesis ; Female ; Follow-Up Studies ; Fractures, Bone - complications ; Humans ; Leg Injuries - complications ; Limb bone fracture ; Male ; Polytetrafluoroethylene ; Retrospective Studies ; Thrombolysis ; Time Factors ; Transplantation, Autologous ; Vascular Patency ; Veins - transplantation ; Venous injury</subject><ispartof>European journal of vascular and endovascular surgery, 1995, Vol.9 (1), p.64-70</ispartof><rights>1995 W. B. Saunders Company Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-74c4189e0b603c84bfaeb25e088048477b8c06d86e99e54b276cb1ed4cf3ad193</citedby><cites>FETCH-LOGICAL-c407t-74c4189e0b603c84bfaeb25e088048477b8c06d86e99e54b276cb1ed4cf3ad193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S1078-5884(05)80227-8$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,4009,27902,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7664015$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Katsamouris, Asterios N.</creatorcontrib><creatorcontrib>Steriopoulos, Kostas</creatorcontrib><creatorcontrib>Katonis, Panos</creatorcontrib><creatorcontrib>Christou, Kostas</creatorcontrib><creatorcontrib>Drositis, John</creatorcontrib><creatorcontrib>Lefaki, Tatiana</creatorcontrib><creatorcontrib>Vassilakis, Sophocles</creatorcontrib><creatorcontrib>Dretakis, Emmanuel</creatorcontrib><title>Limb arterial injuries associated with limb fractures: Clinical presentation, assessment and management</title><title>European journal of vascular and endovascular surgery</title><addtitle>Eur J Vasc Endovasc Surg</addtitle><description>Review of limb arterial injuries associated with limb fractures.
Retrospective study.
University Hospital.
The clinical presentation, assessment and management of 25 patients with upper (seven) and lower (18) limb arterial injuries associated with limb bone fractures has been retrospectively reviewed.
Five patients presented with life threatening injuries and classic signs of acute limb ischaemia, 15 patients had an obvious limb arterial injury, and 5 presented with a suspected limb arterial injury. The site of arterial damage was: superficial femoral (4); popliteal (11); tibioperoneal trunk (3); anterior tibial (4); posterior tibial (3); peroneal (2); axillary (1); brachial (5); radial (4); and ulnar artery (4). The types of arterial repair were: autogenous vein interposition or bypass grafting (17); P.T.F.E. (2); end-to-end anastomosis (14); and ligation (8). The popliteal vein was injured in six cases, repaired in four and ligated in two; the superficial femoral vein was injured in four cases, repaired in three and ligated in one; and the axillary vein was injured in one case and was ligated. Primary nerve repair was employed in six out of seven injured nerves. Skeletal fixation preceded vascular repair in 21 patients and in four a Javid shunt was used. Intraoperative fasciotomy was performed in 12 out of 18 patients with lower limb ischaemia. Completion arteriography revealed residual thrombi in the distal foot of four patients, in whom intraarterial thrombolysis was effective. During the follow-up period of 1.5 to 2 years, the upper and lower limb preservation rate was 100 and 89%, respectively. The upper limb function was judged excellent in five patients, good in one and fair in one. In the lower limbs it was excellent in 11 patients, good in three, fair in one and poor in one.
To ensure life and functional limb salvage of patients with devastating vascular injuries, a well organised multidisciplinary approach is necessary.</description><subject>Acute ischaemia</subject><subject>Adult</subject><subject>Arm Injuries - complications</subject><subject>Arterial injury</subject><subject>Arteries - injuries</subject><subject>Arteriography</subject><subject>Blood Vessel Prosthesis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fractures, Bone - complications</subject><subject>Humans</subject><subject>Leg Injuries - complications</subject><subject>Limb bone fracture</subject><subject>Male</subject><subject>Polytetrafluoroethylene</subject><subject>Retrospective Studies</subject><subject>Thrombolysis</subject><subject>Time Factors</subject><subject>Transplantation, Autologous</subject><subject>Vascular Patency</subject><subject>Veins - transplantation</subject><subject>Venous injury</subject><issn>1078-5884</issn><issn>1532-2165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LxDAQhoMoq67-hIWeRMHqpE2a1IvI4hcseFDPIU2na6Qfa5Iq_nvb3dWrp_l63xnmIWRG4YICzS6fKQgZcynZKfAzCUkiYrlDDihPkzihGd8d8l_JPjn0_h0AOE35hExEljGg_IAsF7YpIu0COqvryLbvvbPoI-19Z6wOWEZfNrxF9SirnDahd-ivonltW2sGx2oosQ062K49H23ofTM0It2WUaNbvcSxPCJ7la49Hm_jlLze3b7MH-LF0_3j_GYRGwYixIIZRmWOUGSQGsmKSmORcAQpgUkmRCENZKXMMM-RsyIRmSkolsxUqS5pnk7JyWbvynUfPfqgGusN1rVuseu9EoLlgiejkG-ExnXeO6zUytlGu29FQY2A1RqwGukp4GoNWMnBN9se6IsGyz_Xlugwv97Mcfjy06JT3lhsDZbWoQmq7Ow_F34AL1OMgw</recordid><startdate>1995</startdate><enddate>1995</enddate><creator>Katsamouris, Asterios N.</creator><creator>Steriopoulos, Kostas</creator><creator>Katonis, Panos</creator><creator>Christou, Kostas</creator><creator>Drositis, John</creator><creator>Lefaki, Tatiana</creator><creator>Vassilakis, Sophocles</creator><creator>Dretakis, Emmanuel</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1995</creationdate><title>Limb arterial injuries associated with limb fractures: Clinical presentation, assessment and management</title><author>Katsamouris, Asterios N. ; Steriopoulos, Kostas ; Katonis, Panos ; Christou, Kostas ; Drositis, John ; Lefaki, Tatiana ; Vassilakis, Sophocles ; Dretakis, Emmanuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-74c4189e0b603c84bfaeb25e088048477b8c06d86e99e54b276cb1ed4cf3ad193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Acute ischaemia</topic><topic>Adult</topic><topic>Arm Injuries - complications</topic><topic>Arterial injury</topic><topic>Arteries - injuries</topic><topic>Arteriography</topic><topic>Blood Vessel Prosthesis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fractures, Bone - complications</topic><topic>Humans</topic><topic>Leg Injuries - complications</topic><topic>Limb bone fracture</topic><topic>Male</topic><topic>Polytetrafluoroethylene</topic><topic>Retrospective Studies</topic><topic>Thrombolysis</topic><topic>Time Factors</topic><topic>Transplantation, Autologous</topic><topic>Vascular Patency</topic><topic>Veins - transplantation</topic><topic>Venous injury</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Katsamouris, Asterios N.</creatorcontrib><creatorcontrib>Steriopoulos, Kostas</creatorcontrib><creatorcontrib>Katonis, Panos</creatorcontrib><creatorcontrib>Christou, Kostas</creatorcontrib><creatorcontrib>Drositis, John</creatorcontrib><creatorcontrib>Lefaki, Tatiana</creatorcontrib><creatorcontrib>Vassilakis, Sophocles</creatorcontrib><creatorcontrib>Dretakis, Emmanuel</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of vascular and endovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Katsamouris, Asterios N.</au><au>Steriopoulos, Kostas</au><au>Katonis, Panos</au><au>Christou, Kostas</au><au>Drositis, John</au><au>Lefaki, Tatiana</au><au>Vassilakis, Sophocles</au><au>Dretakis, Emmanuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limb arterial injuries associated with limb fractures: Clinical presentation, assessment and management</atitle><jtitle>European journal of vascular and endovascular surgery</jtitle><addtitle>Eur J Vasc Endovasc Surg</addtitle><date>1995</date><risdate>1995</risdate><volume>9</volume><issue>1</issue><spage>64</spage><epage>70</epage><pages>64-70</pages><issn>1078-5884</issn><eissn>1532-2165</eissn><abstract>Review of limb arterial injuries associated with limb fractures.
Retrospective study.
University Hospital.
The clinical presentation, assessment and management of 25 patients with upper (seven) and lower (18) limb arterial injuries associated with limb bone fractures has been retrospectively reviewed.
Five patients presented with life threatening injuries and classic signs of acute limb ischaemia, 15 patients had an obvious limb arterial injury, and 5 presented with a suspected limb arterial injury. The site of arterial damage was: superficial femoral (4); popliteal (11); tibioperoneal trunk (3); anterior tibial (4); posterior tibial (3); peroneal (2); axillary (1); brachial (5); radial (4); and ulnar artery (4). The types of arterial repair were: autogenous vein interposition or bypass grafting (17); P.T.F.E. (2); end-to-end anastomosis (14); and ligation (8). The popliteal vein was injured in six cases, repaired in four and ligated in two; the superficial femoral vein was injured in four cases, repaired in three and ligated in one; and the axillary vein was injured in one case and was ligated. Primary nerve repair was employed in six out of seven injured nerves. Skeletal fixation preceded vascular repair in 21 patients and in four a Javid shunt was used. Intraoperative fasciotomy was performed in 12 out of 18 patients with lower limb ischaemia. Completion arteriography revealed residual thrombi in the distal foot of four patients, in whom intraarterial thrombolysis was effective. During the follow-up period of 1.5 to 2 years, the upper and lower limb preservation rate was 100 and 89%, respectively. The upper limb function was judged excellent in five patients, good in one and fair in one. In the lower limbs it was excellent in 11 patients, good in three, fair in one and poor in one.
To ensure life and functional limb salvage of patients with devastating vascular injuries, a well organised multidisciplinary approach is necessary.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>7664015</pmid><doi>10.1016/S1078-5884(05)80227-8</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1078-5884 |
| ispartof | European journal of vascular and endovascular surgery, 1995, Vol.9 (1), p.64-70 |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Acute ischaemia Adult Arm Injuries - complications Arterial injury Arteries - injuries Arteriography Blood Vessel Prosthesis Female Follow-Up Studies Fractures, Bone - complications Humans Leg Injuries - complications Limb bone fracture Male Polytetrafluoroethylene Retrospective Studies Thrombolysis Time Factors Transplantation, Autologous Vascular Patency Veins - transplantation Venous injury |
| title | Limb arterial injuries associated with limb fractures: Clinical presentation, assessment and management |
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