Orthopedic trauma of limbs associated with vascular injuries.
- Author:
Qiang JIE
1
;
Liu YANG
;
Qing-sheng ZHU
;
Ming-quan LI
;
Zhao LI
;
Guang-yue ZHAO
;
Yun-yu HU
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Blood Vessels; injuries; Child; Child, Preschool; Female; Fracture Fixation, Internal; Fractures, Bone; complications; Fractures, Open; complications; Humans; Male; Middle Aged; Prospective Studies
- From: Chinese Journal of Traumatology 2007;10(6):371-375
- CountryChina
- Language:English
-
Abstract:
OBJECTIVETo evaluate the treatment for patients with major vascular injuries associated with traumatic orthopedic injuries.
METHODSA total of 196 patients, aged from 4-67 years with the mean age of 29.88 years, had major vascular injuries associated with traumatic orthopedic injuries and were treated in our hospital in a period of 44 years. The most common mechanism of trauma was blunt trauma (67.3%), open injuries accounted for 32.4% and 54.5% of the injuries were located in the lower extremities. The vascular injury frequently happened in the femoral artery (26.7%) and popliteal artery (20.3%). The treatment principle consisted of aggressive resuscitation, Doppler imaging and stable bone internal fixation with subsequent vascular repair and debridement. The vascular repair for injuries included end-to-end anastomosis (80 cases, 39.6%), interpositional vein graft (94, 46.5%), vascular decompression through fracture distraction (18, 8.9%), arterial ligation (6, 3.0%), vein patch (2, 1.0%), bypass graft (2, 1.0%), venous repair including autogenous vein graft (9, 24.3%) and ligation (28, 75.7%) and prophylactical fasciotomy (15, 7.4%). Postoperative amputation was performed in 16 cases (16.3%).
RESULTSNo intraoperative death was observed and all fractures united within 6 months. Limbs were salvaged in 180 patients (91.8%). Among these patients, early complications were found in 19 patients (9.7%) and late complications were observed in 8 patients (4.1%).
CONCLUSIONSA well-organized approach, based on a specific treatment principle, not only improves clinical outcome but also does good to excellent functional recovery for patients with severe orthopedic injuries and concomitant vascular lesion.