Vascular injuries after extremity trauma

The aim of the present examination was to analyse extremity trauma with additional vascular injuries. Between 1973-2000 78 patients with traumatic peripheral vascular injuries have been treated at the Surgical Department of the University Hospital of Mannheim. In addition to clinical examination Doppler-Duplex ultrasonography (cw-Doppler) was routinely performed. In selected cases either conventional or magnetic resonance angiography completed the diagnostic procedure. Vascular injuries to the upper extremities were found in 46.2% (n = 36) whereas 53.8% (n = 42) of the patients suffered from trauma of the lower extremities. The popliteal artery was affected in 28.2% followed by the brachial artery with 23.1%. 52.6% of the patients had interposition of autologous vein for reconstruction. Only 7.7% of the cases needed interposition of alloplastic material. In general the injured extremity was immobilised by external fixation, followed by secondary vascular reconstruction. An efficient trauma management reduced amputation rate as low as 2.6%.