Journal of Trauma and Injury

  • 제36권1호
  • /
  • Pages.60-64
  • /
  • 2023
  • /
  • 2799-4317(pISSN)
  • /
  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지
DOI QR코드

DOI QR Code

Experience with the emergency vascular repair of upper limb arterial transection with concurrent acute compartment syndrome: two case reports

  • 투고 : 2022.02.26
  • 심사 : 2022.07.11
  • 발행 : 2023.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Upper extremity vascular injuries occurring with acute compartment syndrome are very challenging to manage in an emergency context in resource-poor settings. The need to always recognize the likelihood of coexisting compartment syndrome guides surgeons to perform concomitant fasciotomy to ensure a better outcome. We managed three vascular injuries in the upper extremities in two patients with concomitant imminent compartment syndrome observed intraoperatively. The first injury was complete brachial artery disruption following blunt trauma, while the second and third injuries were radial and ulnar artery transection caused by sharp glass cuts. Both patients were treated with vascular repair and fasciotomy. Secondary wound coverage was applied with split-thickness skin grafting, and the outcomes were satisfactory. Concomitant fasciotomy potentially improves the outcomes of vascular repair in emergency vascular surgery and should be considered for all injuries with the potential for acute compartment syndrome.

키워드

과제정보

The authors appreciate the assistance of the ward nurses in the postoperative management of the patients.

참고문헌

  1. Bravman JT, Ipaktchi K, Biffl WL, Stahel PF. Vascular injuries after minor blunt upper extremity trauma: pitfalls in the recognition and diagnosis of potential "near miss" injuries. Scand J Trauma Resusc Emerg Med 2008;16:16.
  2. Orcutt MB, Levine BA, Gaskill HV, Sirinek KR. Civilian vascular trauma of the upper extremity. J Trauma 1986;26:63-7. https://doi.org/10.1097/00005373-198601000-00012
  3. Hunt CA, Kingsley JR. Vascular injuries of the upper extremity. South Med J 2000;93:466-8. https://doi.org/10.1097/00007611-200093050-00004
  4. Browner BD, DeAngelis JP. Emergency care of musculoskeletal injuries. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston textbook of surgery: the biological basis of modern surgical practice. 18th ed. Saunders; 2008. p. 521-58.
  5. Raza H, Mahapatra A. Acute compartment syndrome in orthopedics: causes, diagnosis, and management. Adv Orthop 2015;2015:543412.
  6. de Silva W, Ubayasiri RA, Weerasinghe CW, Wijeyaratne SM. Challenges in the management of extremity vascular injuries: a wartime experience from a tertiary centre in Sri Lanka. World J Emerg Surg 2011;6:24.
  7. Spaan E, Mathijssen J, Tromp N, McBain F, ten Have A, Baltussen R. The impact of health insurance in Africa and Asia: a systematic review. Bull World Health Organ 2012;90:685-92. https://doi.org/10.2471/BLT.12.102301
  8. Fenny AP, Yates R, Thompson R. Social health insurance schemes in Africa leave out the poor. Int Health 2018;10:1-3. https://doi.org/10.1093/inthealth/ihx046
  9. Farber A, Tan TW, Hamburg NM, et al. Early fasciotomy in patients with extremity vascular injury is associated with decreased risk of adverse limb outcomes: a review of the National Trauma Data Bank. Injury 2012;43:1486-91. https://doi.org/10.1016/j.injury.2011.06.006
  10. Onakpoya UU, Eyekpegha JO, Ogunrombi A, Ohuche AS, Ojo TO. Pattern of extremity arterial injury and outcome of repair in Southwest, Nigeria. Niger J Surg 2019;25:85-90. https://doi.org/10.4103/njs.NJS_18_18
  11. Nwafor IA, Eze JC, Akanni BA. The civilian vascular trauma in a low-income country: the determinant factors of morbidity and mortality. Niger J Med 2020;29:224-8. https://doi.org/10.4103/NJM.NJM_23_20