The Journal of Bone and Joint Surgery, Vol 64, Issue 3 383-387, Copyright © 1982 by Journal of Bone and Joint Surgery, Inc
The results of radial and ulnar arterial repair in the forearm. Experience in three medical centers
RH Gelberman, JA Nunley, LA Koman, JS Gould, PT Hergenroeder, CR MacClean and JR Urbaniak
Sixty-two patients with ninety injuries to the radial or the ulnar artery,
or to both of these arteries, had arterial repairs using microvascular
techniques in three medical centers. Twenty-six of the twenty-eight
patients who had an ischemic hand secondary to injuries to both arteries
and a successful operative repair had at least on patent vessel at
follow-up. Of the other two patients, one had an amputation through the
forearm for ischemia of the hand and the other had a viable hand supplied
by collateral vessels, although both the radial and the ulnar arteries were
thrombosed. The over-all success rate for all repairs was 54 per cent.
After 47 per cent of the one-artery and 57 per cent of the two-artery
lacerations, the vessels were patent at follow-up. Repairs of acute sharp
transections of the radial artery within thirty-six hours of injury were
most successful. Of the factors other than operative technique that
strongly influence vessel patency after repair, back pressure in the distal
arterial stump and the extent of the ischemia of the hand relative to its
normal blood supply (a function of the completeness of the palmar arch)
appear to be the most important.
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