Arterial injuries in children
J. D. Richardson, M. Fallat, H. S. Nagaraj, D. B. Groff and L. M. Flint
Twenty-nine children sustained major arterial injuries secondary to gunshot
wounds (nine), blunt injuries (11), penetrating injuries by sharp objects
(five), and arteriographic injury (four). The femoral artery was most
commonly injured, followed by the brachial, the carotid, subclavian,
popliteal, aorta, innominate, and vertebral arteries. We repaired the
majority of the arterial injuries by resecting the damaged vessel, with
primary anastomosis or interposition grafting when necessary to avoid
tension. Postoperative complications included clotted grafts in two
patients, which were rendered patent by reoperation. Two children died
postoperatively, although both had successful vascular repairs. All
vascular repairs were patent at one year, and limb length disparity has
occurred in one patient following a nerve injury. Our data indicate that
early exploration and repair of all suspected vascular injuries can be
accomplished with excellent results, even in young children.
