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Acute Care Surgery pp 656–674Cite as

Peripheral Vasculature

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Abstract

A high school cheerleader sustains a right supracondylar fracture (radiographic confirmation) after tripping and falling on her outstretched arm. There is evidence of a slight neurologic deficit and vascular insufficiency with diminished distal pulses.The patient has no other injuries and is hemodynamically stable. Which of the following is the most appropriate definitive management approach for the injury?

  1. (A)

    Immobilization of the elbow flexed to 90°

  2. (B)

    Immobilization of the elbow flexed at 45°

  3. (C)

    Traction of the forearm, with countertraction proximally

  4. (C)

    Open exploration and reduction

  5. (E)

    Traction applied to the hyperextended elbow

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References

  1. Allen EV. Thromboangiitis obliterans: methods of diagnosis of chronic occlusive arterial lesions distal to the wrist with illustrative cases. Am J Medical Sci 1929; 1–78:234–244.

    Google Scholar 

  2. Ejrup B, Fischer B, Wright IS. Clinical evaluation of blood flow to the hand: the false-positive Allen test. Circulation 1966; 33:778–780.

    CAS  PubMed  Google Scholar 

  3. Gardner RM, Schwartz R, Wong HC, et al. Percutaneous indwelling radial-artery catheters for monitoring cardiovascular function. Prospective study of the risk of thrombosis and infection. N Engl J Med 1974; 290:1227–1231.

    CAS  PubMed  Google Scholar 

  4. Bedford RF. Long-term radial artery cannulation: effects on subsequent vessel function. Crit Care Med 1978; 6:64–67.

    Article  CAS  PubMed  Google Scholar 

  5. Johnson FE, Sumner DS, Strandness DE Jr. Extremity necrosis caused by indwelling arterial catheters. Am J Surg 1976; 131:375–379.

    Article  CAS  PubMed  Google Scholar 

  6. Comerota AJ, Malone MD. Simplified approach to thrombolytic therapy of arterial and graft occlusion. In Yao JST, Pearce WH, eds. Practical Vascular Surgery. Stamford, CT: Appleton & Lange, 1999: 321–334.

    Google Scholar 

  7. Mattox KL, Feliciano DV, Burch J, et al. Five thousand seven hundred sixty cardiovascular injuries in 4459 patients. Epidemiologic evolution 1958 to 1987. Ann Surg 1989; 209:698–707.

    Article  CAS  PubMed  Google Scholar 

  8. Frykberg ER, Schinco MA. Peripheral vascular injury. In Moore EE, Feliciano DV, Mattox KL, eds. Trauma, 5th ed. New York: McGraw-Hill, 2004: 969–1003.

    Google Scholar 

  9. DeBakey ME, Simeone FA. Battle injuries of the arteries in World War II. An analysis of 2,471 cases. Ann Surg 1946; 123:534–579.

    Article  CAS  PubMed  Google Scholar 

  10. O’Gorman RB, Feliciano DV. Arteriography performed in the emergency center. Am J Surg 1986; 152:323–325.

    Article  PubMed  Google Scholar 

  11. Frykberg ER, Vines FS, Alexander RH. The natural history of clinically occult arterial injuries: a prospective evaluation. J Trauma 1989; 29:577–583.

    Article  CAS  PubMed  Google Scholar 

  12. Stain SC, Yellin AE, Weaver FA, et al. Selective management of nonocclusive arterial injuries. Arch Surg 1989; 124:1136–1141.

    CAS  PubMed  Google Scholar 

  13. Wind GG, Valentine RJ. Axillary artery. In Wind GG, Valentine RJ, eds. Anatomic Exposures in Vascular Surgery. Baltimore: William & Wilkins, 1991: 138–157.

    Google Scholar 

  14. Graham JM, Mattox KL, Feliciano DV, et al. Vascular injuries of the axilla. Ann Surg 1982; 195:232–238.

    Article  CAS  PubMed  Google Scholar 

  15. Feliciano DV. Managing peripheral vascular trauma. Infect Surg 1986; 5:659–669, 682.

    Google Scholar 

  16. Carrell A. The surgery of blood vessels. Johns Hopkins Hosp Bull 1907; 18:18–28.

    Google Scholar 

  17. The Dutch Bypass Oral Anticoagulants or Aspirin Study Group. Efficacy of oral anticoagulants compared with aspirin after infrainguinal bypass surgery. The Dutch Bypass Oral Anticoagulants or Aspirin (BOA) Study: a randomized trial. Lancet 2000; 355:346–351.

    Article  PubMed  Google Scholar 

  18. Feliciano DV. Heroic procedures in vascular injury management. The role of extra-anatomic bypasses. Surg Clin North Am 2002; 82:115–124.

    Article  PubMed  Google Scholar 

  19. Feliciano DV. Evaluation and treatment of vascular injuries. In Browner BD, Jupiter JB, Levine AM, Trafton PG, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. Philadelphia: W.B. Saunders, 2003: 250–267.

    Google Scholar 

  20. Feliciano DV, Moore EE, Mattox KL. Trauma damage control. In Moore EE, Feliciano DV, Mattox KL, eds. Trauma, 5th ed. New York: McGraw-Hill, 2004: 877–900.

    Google Scholar 

  21. Sharma PVP, Shah PM, Vinzons AT, et al. Meticulously restored lumina of injured veins remain patent. Surgery 1992; 112:928–932.

    CAS  PubMed  Google Scholar 

  22. Parry NG, Feliciano DV, Burke RM, et al. Management and short-term patency of lower extremity venous injuries with various repairs. Am J Surg 2003; 186:631–635.

    Article  PubMed  Google Scholar 

  23. Matsen FA III. Compartmental Syndromes. New York: Grune & Stratton, 1980.

    Google Scholar 

  24. Amendola A, Twaddle BC. Compartment syndromes. In Browner BD, Jupiter JB, Levine AM, Trafton PG, eds. Skeletal Trauma:. Basic Science, Management, and Reconstruction. Philadelphia: W.B. Saunders, 2003: 268–292.

    Google Scholar 

  25. Feliciano DV, Cruse PA, Spjut-Patrinely V, et al. Fasciotomy after trauma to the extremities. Am J Surg 1988; 156:533–536.

    Article  CAS  PubMed  Google Scholar 

  26. Mubarak SJ, Hargens AR. Compartment syndromes and Volkmann’s contracture. Philadelphia: W.B. Saunders, 1981:117.

    Google Scholar 

  27. Whitesides TE Jr, Heckman MM. Acute compartment syndrome: update on diagnosis and treatment. J Am Acad Orthop Surg 1996; 4:209–218.

    PubMed  Google Scholar 

  28. McQueen MM, Court-Brown CM. Compartment monitoring in tibial fractures. The pressure threshold for decompression. J Bone Joint Surg Br 1996; 78:99–104.

    CAS  PubMed  Google Scholar 

  29. Feliciano DV. Management of peripheral vascular trauma (Poster). American College of Surgeons Committee on Trauma/Subcommittee on Publications. Chicago: American College of Surgeons, 2002.

    Google Scholar 

  30. Skillman JJ, Kim D, Baim DS. Vascular complications of percutaneous femoral cardiac interventions. Incidence and operative repair. Arch Surg 1988; 123:1207–1212.

    CAS  PubMed  Google Scholar 

  31. Cutler BS, Okike ON, Vander Salm TJ. Surgical versus percutaneous removal of the intra-aortic balloon. J Thorac Cardiovasc Surg 1983; 86:907–911.

    CAS  PubMed  Google Scholar 

  32. Franco CD, Goldsmith J, Ohki T, et al. Iatrogenic vascular injury. In Hobson RW II, Wilson SE, Veith FJ, eds. Vascular Surgery: Principles and Practice, 3rd ed, revised and expanded. New York: Marcel Dekker, 2004: 1098.

    Google Scholar 

  33. Franco CD, Goldsmith J, Veith FJ, et al. Management of arterial injury produced by percutaneous femoral procedures. Surgery 1993; 113:419–425.

    CAS  PubMed  Google Scholar 

  34. Hajarizadeh H, LaRosa CR, Cardullo P, et al. Ultrasoundguided compression of iatrogenic femoral pseudoaneurysm. Failure, recurrence, and long-term results. J Vasc Surg 1995; 22:425–433.

    Article  CAS  PubMed  Google Scholar 

  35. Mills JL, Porter JM. Basic data related to clinical decisionmaking in acute limb ischemia. Ann Vasc Surg 1991; 5:96–98.

    Article  CAS  PubMed  Google Scholar 

  36. Sharp LS, Rozycki GS, Feliciano DV. Rhabdomyolysis and secondary renal failure in critically ill surgical patients. Am J Surg 2004; 188:801–806.

    Article  PubMed  Google Scholar 

  37. Blaisdell FW, Steele M, Allen RE. Management of acute lower extremity arterial ischemia due to embolism and thrombosis. Surgery 1978; 84:822–831.

    CAS  PubMed  Google Scholar 

  38. Short D, Vaughn GD III, Jachimczyk J, et al. The anatomic basis for the occasional failure of transfemoral balloon catheter thromboembolectomy. Ann Surg 1979;190:555–556.

    Article  CAS  PubMed  Google Scholar 

  39. Wilson SE, Van Wagenen P, Passaro E Jr. Arterial infection. Curr Probl Surg 1978; 15:1–89.

    Article  CAS  PubMed  Google Scholar 

  40. Strinden WD, Dibbell DG Sr, Turnipseed WD, et al. Coverage of acute vascular injuries of the axilla and groin with transposition muscle flaps: case reports. J Trauma 1989; 29:512–516.

    Article  CAS  PubMed  Google Scholar 

  41. Ting AC, Cheng SW. Femoral pseudoaneurysms in drug addicts. World J Surg 1997; 21:783–787.

    Article  CAS  PubMed  Google Scholar 

  42. DePalma RG, Hubay CA. Arterial bypass via the obturator foramen. An alternative in complicated vascular problems. Am J Surg 1968; 115:323–328.

    Article  CAS  PubMed  Google Scholar 

  43. Fromm SH, Lucas CE. Obturator bypass for mycotic aneurysm in the drug addict. Arch Surg 1970; 100:82–83.

    CAS  PubMed  Google Scholar 

  44. Valentine RJ, Clagett GP. Aortic graft infections: replacement with autogenous vein. Cardiovasc Surg 2001; 9:419–425.

    Article  CAS  PubMed  Google Scholar 

  45. Wind GG, Valentine RJ. Axillary artery. In Wind GG, Valentine RJ, eds. Anatomic Exposures in Vascular Surgery. Baltimore: William & Wilkins, 1991: 384–388.

    Google Scholar 

  46. Feliciano DV, Herskowitz K, O’Gorman RB, et al. Management of vascular injuries in the lower extremities. J Trauma 1988; 28:319–328.

    Article  CAS  PubMed  Google Scholar 

  47. Bermudez KM, Knudson MM, Nelken NA, et al. Long-term results of lower-extremity venous injuries. Arch Surg 1997; 132:963–968.

    CAS  PubMed  Google Scholar 

  48. Yelon JA, Scalea TM. Venous injuries of the lower extremities and pelvis: repair versus ligation. J Trauma 1992; 33:532–536.

    Article  CAS  PubMed  Google Scholar 

  49. Timberlake GA, O’Connell RC, Kerstein MD. Venous injury: to repair or ligate—the dilemma. J Vasc Surg 1986; 4:553–558.

    Article  CAS  PubMed  Google Scholar 

  50. Mullins RJ, Lucas CE, Ledgerwood AM. The natural history following venous ligation for civilian injuries. J Trauma 1980; 20:737–743.

    Article  CAS  PubMed  Google Scholar 

  51. Rich NM, Hobson RW, Collins GJ Jr, et al. The effect of acute popliteal venous interruption. Ann Surg 1976; 183:365–368.

    Article  CAS  PubMed  Google Scholar 

  52. Feliciano DV, Mattox KL, Graham JM, et al. Five-year experience with PTFE grafts in vascular wounds. J Trauma 1985; 25:71–82.

    Article  CAS  PubMed  Google Scholar 

  53. Pappas PJ, Haser PB, Teehan EP, et al. Outcome of complex venous reconstructions in patients with trauma. J Vasc Surg 1997; 25:398–404.

    Article  CAS  PubMed  Google Scholar 

  54. Zamir G, Berlatzky Y, Rivkind A, et al. Results of reconstruction in major pelvic and extremity venous injuries. J Vasc Surg 1998; 28:901–908.

    Article  CAS  PubMed  Google Scholar 

  55. Tremblay LN, Feliciano DV, Rozycki GS. Secondary extremity compartment syndrome. J Trauma 2002; 53:833–837.

    Article  PubMed  Google Scholar 

  56. Amendola A, Twaddle BC. Compartment syndromes. In Browner BD, Jupiter JB, Levine AM, Trafton PG, eds. Skeletal Trauma: Basic Science, Management and Reconstruction. Philadelphia: W.B. Saunders, 2003: 268–292.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA

    David V. Feliciano MD

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  1. David V. Feliciano MD
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Editors and Affiliations

  1. Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA

    L. D. Britt MD, MPH (Brickhouse Professor of Surgery and Chairman) (Brickhouse Professor of Surgery and Chairman)

  2. Department of Surgery, Oregon Health Sciences University, Portland, OR, USA

    Donald D. Trunkey MD (Professor) (Professor)

  3. Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA

    David V. Feliciano MD (Professor of Surgery, Chief of Surgery) (Professor of Surgery, Chief of Surgery)

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Feliciano, D.V. (2007). Peripheral Vasculature. In: Britt, L.D., Trunkey, D.D., Feliciano, D.V. (eds) Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69012-4_40

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  • DOI: https://doi.org/10.1007/978-0-387-69012-4_40

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-34470-6

  • Online ISBN: 978-0-387-69012-4

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