RADIAL OR ULNAR ARTERY LACERATION - REPAIR OR LIGATE

Objective: To determine the relationship between patency of radial or ulnar artery repair and later hand symptoms. Design: Call-back survey. Setting: Urban trauma center. Patients: Thirty-two subjects with wris t artery lacerations undergoing 26 arterial repairs and six artery lig ations during an 8-year period. Interventions: Directed history and ha nd examination (palpation of wrist pulses, Doppler Allen test, and Dop pler interrogation of palmar arch and digital vessels). Main Outcome M easures: History of hand claudication, weakness, or cold sensitivity o r paresthesias and patency of wrist arteries. Results: Twelve (46%) of 26 wrist artery repairs were patent. There was no evident benefit of optical magnification or specialization in hand or vascular surgery. N o subjects had hand claudication; there was a 50% incidence of hand we akness and a 12% incidence of cold sensitivity independent of patency of the damaged wrist artery and present only in subjects with associat ed nerve injury. Professional charges for wrist artery repair were thr eefold to fourfold higher than those for wrist artery ligation. Conclu sions Consonant with prior reports, patency following repair of radial or ulnar artery laceration does not exceed 50%. Later hand symptoms r elate to nerve or tendon damage, not to arterial patency. In the absen ce of acute hand ischemia, simple ligation of a lacerated radial or ul nar artery is safe and cost-effective.