ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
VASCULAR INJURY ASSOCIATED WITH FRACTURE OR DISLOCATION OF EXTREMITIES
İbrahim GÖKŞİN, Gökhan ÖNEM, Mustafa SAÇAR, Oya RENDECİ, Ahmet BALTALARLI,*Levent YILIK, *Engin TULUKOĞLU
Pamukkale Üniversitesi Tıp Fakültesi Göğüs Kalp Damar Cerrahisi Ana Bilim Dalı, Denizli

* Atatürk Eğitim Araştırma Hastanesi Kalp Damar Cerrahisi Kliniği, İzmir

Background: The aim of the study is to review our experience in patients with vasculary injuries complicated by fracture or dislocation of extremities.

Metods: This study is included 20 patients with vasculary injuries complicated by fracture or dislocation of extremities, admiting to our hospital between February to September 1999. Nine penetrating wound and 11 blunt injuries occured in 16 men and 4 women the age of patients ranged between 8 and 47 years. Most of vasculary injuries were seen in lower extremities (80%). The mean time between injury and surgery was 5.8 ± 3.7 hours. Two preoperatif angiography was performed. Two primary amputation was performed without attempted salvage. Two legs were amputated secondarily from 2 days to 17 days after initial injury despite intensive efforts to save them.

Result: Totally 19 arterial and 15 venous reconstructions were performed. Vascular reconstructions was primarly performed in 3 of 11 patients in whom internally or externally fixation needed for orthopedic stabilization. Except for 1 patient with subclavian artery injury in whom 8 mm PTFE greft was used for reconstruction, saphenous vein was used for all the other reconstructions. Four fasciotomies were performed on the 16 lower extremity vascular injuries.

Conclusions: The patients, who have vascular injury associated with fracture and dislocation of extremity, should be operated on without arteriography. Orthopedic stabilization sould be performed first before revascularization in patient with no active bleeding and no ischemic sign in injured extremity. A fasciotomy should be performed in patients with the long ischemic time or if venous reconstruction has been performed, or if there has been large soft tissue injury, or if postoperative compartment syndrome has developed. Venous reconstruction should also be performed if injured vein has been sole and major source for venous return. Otogenic vein greft for vascular recontruction should be used primarly.

Keywords : Vasküler injury, orthopedic fracture, dislocation, extremity
Viewed : 11815
Downloaded : 2022