Vascular Injuries of the Upper Arm
SUVIT SRIUSSADAPORN, M.D.*
Affiliation : * Department of Surgery, Faculty of Medicine, Chulalongkom University, Bangkok 10330, Thailand.
Abstract Twenty eight patients who had subclavian, axillary, and brachial artery injuries were studied. Sixteen (57%) sustained blunt trauma and 12 (43%) sustained penetrating trauma. Motor cycle acci- dents were the most common cause of injuries (43%). Twenty patients (71.4%) were transferred from other hospitals. Nine patients (32%) were in shock on arrival. All patients had radial pulse abnorma- lities (3 decreased, 25 absent) of the affected limbs. Eighteen patients (64%) had associated injuries to other parts of the body. Eighteen patients (64%) also had associated nerve injuries, 7 of them had complete brachial plexus injuries from motor cycle accidents. Twelve patients (43%) had preopera- tive angiography. Twelve patients (43%) had brachial, 10 (35.7%) had axillary, 2 (7%) had axillary- subclavian, and 4 (14%) had subclavian artery injuries. Eight patients (28.6%) had concomitant venous injuries. Resection of the injured artery and reversed saphenous vein graft were performed in 23 patients (82%). The remaining had resection and end to end anastomosis in 3 patients (10.7%), lateral repair in 2 patients (7% ), and ligation in 1 patient (3.6% ). Concomitant venous repairs were performed in 5 patients. Fasciotomies were performed in 2 patients (7% ). Excellent results of vas- cular repairs were obtained in all patients. Long-term disability occurred in patients who had asso- ciated nerve injuries. Avulsion injury of the brachial plexus usually resulted in severe impairment of limb function.
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