THE ROLE OF DUPLEX ULTRASOUND ARTERIAL IMAGING IN PATIENTS WITH PENETRATING EXTREMITY TRAUMA

Objective: To investigate the role of color-flow duplex ultrasound vas cular imaging in screening patients for potential arterial injuries fo llowing penetrating trauma of the extremities. Design: ln this prospec tive study, patients with penetrating trauma in proximity to major per ipheral vessels but without signs of arterial injury underwent color-f low duplex imaging. Patients with abnormal color-flow duplex examinati on results were then studied with angiography, and the results of the two studies were compared. In patients who presented with signs of art erial injury, immediate operative exploration and/or angiography was p erformed. Setting: An urban trauma center. Patients: Patients entering the trauma center with penetrating trauma between April 1991 and Dece mber 1992. Results: Seventy-seven patients with 86 extremity injuries were initially screened with color-flow duplex imaging. Four patients had positive study results, and all injuries were confirmed with angio graphy (100% true positive). No missed arterial injuries were detected in dinical follow-up. Conclusions: Color-flow duplex imaging reliably detects occult arterial injuries and may also have a role in followin g up minor injuries treated without surgery.