Diagnosis and treatment of vascular injury in limbs

OBJECTIVE To report the diagnosis methods and clinical treatment effects of blood vessel trunk damage in limbs. METHODS From January 2001 to June 2006, 72 patients with vascular injury in limbs were treated. There were 50 males and 22 females, aged from 5-60 years (median 39 years) and including 44 cases of open injury and 28 cases of closed injury. The locations were subclavian artery in 1, femoral artery in 23, popliteal artery in 20, radia artery and ulna artery in 12, brachial artery in 11, axillary artery in 3 and anterior and posterior tibia artery in 2. The disease course was 30 minutes to 27 days. Injured arteries were repaired by suturing directly in 3 cases, by end-end anastomosis in 39 cases and by saphenous transplantation in 30 cases. The length of transplant veins was 3 cm to 8 cm. RESULTS In 72 cases, 67 survived and 5 were given amputation. Forty-eight cases were followed up 6 months to 5 years. The blood flow rate and the diameter of blood vessel on the affected limbs were not different from that of normal limbs by colorful Doppler blood flow monitor. Forty cases recovered satisfactory limb function. Eight cases had different degrees of dysfunction, of them, four cases received functional reconstructive operation, and the function and appearance were improved. CONCLUSION To investigate the mechanism and situation of injury, to examine patients carefully and analyze comprehensively are the key points of making earlier diagnosis for branch blood vessel damage; microsurgical repair of the injured blood vessel is the assurance of the blood flow rate. For the blood vessel above elbow and knee injured and lacked blood supply more than 4 hours and fascia syndrome, earlier opening the fascia cavity is the effective methods to recover the function of the limbs and to avoid disability.