MANAGEMENT OF BLUNT VASCULAR TRAUMA TO THE EXTREMITIES

During a seven and one-half year period from 1984 to 1991, 106 patient s admitted to a Level I trauma center had blunt vascular injury to the extremities. This subset of patients was analyzed with respect to mec hanism of injury, associated injuries, method of repair, morbidity and mortality. Twenty patients sustained vascular injuries of the upper l imb. Eighty percent of the patients (16 patients) underwent primary va scular repairs, 15 percent had primary amputations and 5 percent (one patient) were observed. Eighty-eight percent (14 of 16 repairs) of the vascular repairs demonstrated excellent neurologic function postopera tively. Eighty-six patients had arterial injuries of the lower extremi ty. Forty-eight percent (41 patients) of the injured legs were amputat ed, 41 percent (35 patients) underwent vascular repairs, 6 percent (fi ve patients) underwent ligation of the primary vessel with no amputati on and 24 percent (21 patients) underwent no surgical procedure. Sixty -two percent of the 37 patients (23 patients) with popliteal injuries required amputation and 57 percent (21 patients) underwent vascular re pair. The overall mortality rate was 11 percent-zero percent for injur ies to the upper limb and 14 percent for injuries to the lower limb.