Determination of Functional Outcome Following Upper Extremity Arterial Trauma

• Published in: Vascular and endovascular surgery 2007-04, Vol.41 (2), p.111-114
• Main Authors: Joshi, Vijay, Harding, Gregory E.J., Bottoni, David A., Lovell, Marge B., Forbes, Thomas L.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Arm - blood supply; Arm - physiopathology; Axillary Artery - injuries; Axillary Artery - physiopathology; Axillary Artery - surgery; Biological and medical sciences; Brachial Artery - injuries; Brachial Artery - physiopathology; Brachial Artery - surgery; Cardiovascular system; Female; Follow-Up Studies; Hand - blood supply; Hand - physiopathology; Humans; Injury Severity Score; Investigative techniques of hemodynamics; Investigative techniques, diagnostic techniques (general aspects); Length of Stay; Male; Medical sciences; Middle Aged; Neurosurgery; Orthopedic Procedures; Psychomotor Performance; Radial Artery - injuries; Radial Artery - physiopathology; Radial Artery - surgery; Research Design; Retrospective Studies; Shoulder - blood supply; Shoulder - physiopathology; Skull, brain, vascular surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Vascular Surgical Procedures; Wounds, Nonpenetrating - physiopathology; Wounds, Nonpenetrating - surgery; Wounds, Penetrating - physiopathology; Wounds, Penetrating - surgery
• ISSN: 1538-5744; 1938-9116
• DOI: 10.1177/1538574406291338

Upper extremity arterial trauma may lead to significant disability with a poor functional outcome. This study represents a retrospective review of all trauma patients presenting to a university-affiliated medical center. Patients suffering from upper extremity arterial injuries requiring treatment were identified. The injured vessels were identified along with the mechanism of injury and method of repair. The degree of functional disability was evaluated by using a previously validated questionnaire, the Disabilities of the Arm, Shoulder, and Hand (DASH) Outcome Measure. Between September 1999 and December 2004, 17 patients presented with traumatic arterial injury to the upper extremity, with 9 and 8 patients suffering from blunt and penetrating traumas, respectively. One patient required amputation representing a limb salvage rate of 94%. The mean length of hospitalization was significantly shorter for penetrating trauma (5.1 vs 12 days, P = .03), with blunt trauma victims being more prone to coexisting orthopedic injuries (P = .009). Length of follow-up did not differ between the 2 groups and ranged from 1-60 months. Patients with blunt trauma tended, although not statistically significant, to have higher DASH scores (61.8 vs 22.8, P = .08), indicating a greater degree of disability. By utilizing a validated disability questionnaire, this study confirms that patients suffering from blunt injuries to upper extremity arteries are more likely to have greater degrees of disability affecting everyday activities.