The role of duplex ultrasound arterial imaging in patients with penetrating extremity trauma
M. M. Knudson, F. R. Lewis, K. Atkinson and A. Neuhaus
University of California, San Francisco.
OBJECTIVE: To investigate the role of color-flow duplex ultrasound vascular
imaging in screening patients for potential arterial injuries following
penetrating trauma of the extremities. DESIGN: In this prospective study,
patients with penetrating trauma in proximity to major peripheral vessels
but without signs of arterial injury underwent color-flow duplex imaging.
Patients with abnormal color-flow duplex examination results were then
studied with angiography, and the results of the two studies were compared.
In patients who presented with signs of arterial injury, immediate
operative exploration and/or angiography was performed. SETTING: An urban
trauma center. PATIENTS: Patients entering the trauma center with
penetrating trauma between April 1991 and December 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 angiography (100% true positive). No
missed arterial injuries were detected in clinical follow-up. CONCLUSIONS:
Color-flow duplex imaging reliably detects occult arterial injuries and may
also have a role in following up minor injuries treated without surgery.
