Abstract:

Between January-1985 and July-2000, 518 patients with upper-extremity vascular injuries were treated at our de­ partment. 491 cases were male (95%), 27 cases were female (5%) and the mean age was 23.2 years (range, 3 to 70 years). The causes of injuries were related to penetrating deviced with 326(63%), gun shots with 101(20%), blunt trauma with 91(17%). Localisation of the injuries were subclavian artery in 5(1%) cases, axillary artery in 27(5%), brachial artery in 159(31%), radial/ulnar artery in 56(11%), radial artery in 150(29%), ulnar artery in 121(23%) cases. Arterial injuries accompanied with 49(9%) venous injuries, 135(26%) nerve injuries, 118(:0%) tendon transection, 70(14%) bone fracture and 19(4%) extensive tissue defect. The injured arteries were treatt-:d by end to end anosto­ mosis in 390 (68%) patients, saphenous vein interposition grafting in 110 (19%), cephalic/basilic vein interposition gratting in 32 (6%), lateral suture in 15(3%), synthetic graft replacement in 8 (1%), trombectomy in 7 (1%) and liga­ tion in 12 (2%) patients. Fasciotomy was performed in 13 cases. Three (0.5%) patients underwent amputation. Mor­ tality was 0.5% (3 cases). Asa resul!, lale intervention, blunt trauma, extensive sofi tissue defect and bone fractures have significantly increased the amputation rate. Early intervention, replacement of blood volume, decreasing the severity of ischemia by fasciotomy and usage ot systemic anticoagulation would decrease the morbitidy and mortality rates.

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