Data di Pubblicazione:
2019
Citazione:
Arterial lesions in osteoarticular trauma of the lower limbs / B. Derbel, D. Mazzaccaro, A. Hfayedh, J. Ziadi, R. Miri, G. Nano, G. Faker, R. Denguir. - In: ANNALI ITALIANI DI CHIRURGIA. - ISSN 2239-253X. - 90:4(2019 Aug), pp. PII S0003469X1903080X.364-PII S0003469X1903080X.370.
Abstract:
Objective: To evaluate in-hospital mortality and limb salvage of a series of patients presenting with arterial injury of the lower limbs complicating an osteoarticular trauma, and to determine any preoperative predictive factors of limb salvage.
Methods: Data of consecutive patients treated between 01/2007 and 12/2017 were retrospectively analyzed. Primary outcomes were in-hospital mortality and limb salvage. Multivariate analysis was performed to assess any variable that could affect limb salvage. P values <0.05 were considered statistically significant.
Results: The postoperative course, death occurred in 2 patients Lower limb amputation was performed in 13 cases (15.6%). The main factors predicting limb amputation were the timing of staged surgery, in particular when bone stabilization was performed first (P<0.001), and a delay Data concerning 74 patients with 83 traumatized lower limbs were analyzed. Most vascular lesions were located at the popliteal artery (47, 63.5%). Surgical bone stabilization was performed as a first step in 45 patients (60.8% of cases), followed by a delayed arterial repair. The median time to revascularization was 14.3 hours (range from 2 hours to 6 days). In 29 patients (39.2%) vascular repair and bone stabilization were performed simultaneously. During to limb revascularization longer than 6 hours (P<0.001). The location of injury at the popliteal artery (P=0.005), the presence of infection (P<0.001), and the severe ischemic signs at presentation (P=0.001) also were factors associated with amputation.
Conclusions: The timing of staged surgical repair and the revascularization delay were the main predictor factors of limb salvage.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Adolescent; Adult; Aged; Aged, 80 and over; Blood Vessels; Bone and Bones; Child; Female; Hospital Mortality; Humans; Joints; Leg; Leg Injuries; Limb Salvage; Male; Middle Aged; Multiple Trauma; Retrospective Studies; Vascular Surgical Procedures; Young Adult
Elenco autori:
B. Derbel, D. Mazzaccaro, A. Hfayedh, J. Ziadi, R. Miri, G. Nano, G. Faker, R. Denguir
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