Pediatric vascular trauma. Manifestations, management, and sequelae of extremity arterial injury in patients undergoing surgical treatment
W. M. Whitehouse, A. G. Coran, J. C. Stanley, L. R. Kuhns, W. H. Weintraub and W. J. Fry
Twenty pediatric patients with a mean age of 9.2 years exhibited 21
injuries to arteries of an extremity and underwent operation. Included were
12 iatrogenic injuries and nine non-iatrogenic penetrating injuries.
Femoral, brachial, popliteal, radial, axillary, iliac, and tibial arteries
were sites of vascular trauma. Long-term follow-up, averaging 36 months,
was possible in 14 patients. Postoperative scanograms, digital impedance
plethysmographic studies, and bone age roentgenograms were routinely
obtained. Limb length disparities greater than 5 mm, extremity blood
pressure differentials greater than 10 mm Hg, and bone age retardation were
encountered. Proper treatment of pediatric patients with acute arterial
injuries of an extremity requires early operative intervention and
continuous postoperative follow-up during years of active growth. If
chronic arterial insufficiency ensues, arteriographic studies should be
obtained and arterial reconstruction undertaken.
