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Manifestations, Management, and Sequelae of Extremity Arterial Injury in Patients Undergoing Surgical Treatment

Walter M. Whitehouse, Jr, MD; Arnold G. Coran, MD; James C. Stanley, MD; Lawrence R. Kuhns, MD; William H. Weintraub, MD; William J. Fry, MD

Arch Surg. 1976;111(11):1269-1275.

Abstract
• 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 noniatrogenic 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.

(Arch Surg 111:1269-1275, 1976)

Author Affiliations
From the Departments of Surgery (Drs Whitehouse, Coran, Stanley, Weintraub, and Fry) and Radiology (Dr Kuhns), University of Michigan Medical Center, Ann Arbor.

Footnotes
Accepted for publication July 9, 1976.

Read before the 24th scientific meeting of the International Cardiovascular Society, Albuquerque, NM, June 19, 1976.

Reprint requests to Department of Surgery, University Hospital, 1405 E Ann St, Ann Arbor, MI 48109 (Dr Whitehouse).

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