VASCULAR TRAUMA OF THE UPPER-LIMB AND ASSOCIATED NERVE INJURIES

In an analysis of vascular audit data on upper limb vascular trauma ov er a 10 year period in a major UK injury centre it was found that 15 p atients required operation for subclavian or axillary artery injuries. Eleven cases were the result of blunt injury. Twelve patients had an ischaemic arm on presentation, all of whom had an associated brachial plexus lesion. Subclavian or axillary artery transections, irrespectiv e of limb viability, also were found to have associated plexus trauma. Twenty-eight patients had brachial artery injuries repaired, 46 per c ent of whom had an associated nerve injury. A good functional result w as achieved in only half of the patients who underwent repair of a per ipheral nerve injured in association with the brachial artery. Vascula r reconstruction was successful in all cases. The long-term outcome of brachial plexus lesions was very poor and the role of exploratory sur gery is discussed. The long-term outcome of upper limb injury is not d ependent on the vascular injury which can be successfully managed, but upon the recognition, treatment, and outcome of the associated nerve injuries.