Wolosker N, Guimarães P C, Gaudêncio A, Kuzniec S, Scheinman M, Aun R, Langer B
Hospital das Clínicas, Medical School of the São Paulo University, Brazil.
Sao Paulo Med J. 1994 Jan-Mar;112(1):485-8. doi: 10.1590/s1516-31801994000100002.
Trauma to arteries of the forearm corresponds to 20% of total arterial trauma. The authors analyzed 24 patients with non iatrogenic trauma of the forearm arteries, cared for from January 1987 to December 1990. All patients were male, trauma by penetrating instrument was the most frequent, with 21 cases (87.5%), absence of pulses was the most frequent clinical manifestation (62.5%), fifteen patients did not present ischemic manifestations (54.2%) and half of the patients did not exhibit neurological symptoms. Injury to only one artery was found in 11 cases, five of them in the radial artery (20.8%), five in the ulnar artery (20.8%) and one in the interosseous artery (4.2%). Concurrent injury to the radial and ulnar arteries was found in 13 cases (54.1%). Regarding nervous impairment, injury to the radial nerve was found in four cases (16.6%) and of the median and ulnar nerves, one case in each (4.1%). All patients with concurrent injury to the ulnar and radial arteries (13) were submitted to arterial restoration. The 11 patients with injury to a sole artery of the forearm were managed as follows: ligature of the interosseous artery in one case, ligature of the radial artery in four cases, raphe of the radial artery in one case, ligature of the ulnar artery in three cases, restoration of the ulnar artery using a segment of the v. saphena in the two cases in which the Allen test had been positive. One patient died in the immediate postoperative period as a result of multiple organ failure due to polytraumatism.(ABSTRACT TRUNCATED AT 250 WORDS)
前臂动脉创伤占总动脉创伤的20%。作者分析了1987年1月至1990年12月期间收治的24例非医源性前臂动脉创伤患者。所有患者均为男性,最常见的创伤原因是锐器穿透伤,共21例(87.5%),最常见的临床表现是无脉(62.5%),15例患者无缺血表现(54.2%),半数患者无神经症状。11例患者仅损伤一条动脉,其中5例为桡动脉(20.8%),5例为尺动脉(20.8%),1例为骨间动脉(4.2%)。13例(54.1%)患者同时存在桡动脉和尺动脉损伤。关于神经损伤,4例(16.6%)患者出现桡神经损伤,正中神经和尺神经各有1例(4.1%)损伤。所有同时存在尺动脉和桡动脉损伤的13例患者均接受了动脉修复。11例仅前臂单条动脉损伤的患者治疗如下:1例骨间动脉结扎,4例桡动脉结扎,1例桡动脉缝合,3例尺动脉结扎,2例Allen试验阳性患者采用一段大隐静脉修复尺动脉。1例患者术后因多发伤导致多器官功能衰竭立即死亡。(摘要截选至250字)