The injuries of the femoral arteries were mistreated in 5 cases. The causes of the mistakes were resulted from: the initial cause of the injury was not carefully analyzed; the arterial injury was overlooked by the concomitant injuries, and the improper method of management was selected, as a result, 2 patients died from acute renal failure and the other 3 patients developed the complications of secondary thrombosis of the artery or rupture of the artery at the anastomotic site following repair. Of the 3 patients, 2 patients had recovered following reoperation and the other 1 patient had lost his limb from amputation. It should be emphasized that all of the following key points might avoid the mistakes occurred in the management of the injury of the femoral artery: (1) early diagnosis; (2) debredment of arteral end; (3) in infections wounds, insted of vein transplantation bypass technique should be done.
To explore the effectiveness and methods of intervention assistant operation in the treatment of phalanx closed fracture combined with artery crisis. Methods Between August 2002 and December 2008, 24 cases (31 toes) of phalanx closed fracture combined with artery crisis were treated. There were 17 males (22 toes) and 7 females (9 toes), aged from 16 to 62 years (mean, 38 years). The causes of injury included crush and bruise (20 cases), traffic accident (3 cases),and machine twist (1 case). The locations were the first toe (19 toes), the second toe (10 toes), and the third toe (2 toes). The period between injury and hospital ization was 1-10 hours (mean, 6.8 hours). Phalanx angiography was performed by using venous indwell ing needle for dorsal is pedis artery and posterior tibial artery puncture; according to angiography results, proper treatment could be done, then the constrast medium was injected to the artery to observe the blood supply. According to different types and locations of fracture, Kirschner wire and plate were choosen to fix fracture after the blood supply were recovered. Results Two cases (2 toes) received amputation due to necrosis at 4 days and 6 days after interventional therapy, respectively. Twenty-two cases (29 toes) survived. Incision healed primarily in 21 cases. Exudation occurred at wound of 1 case and was cured at 3 weeks after dressing change. Twenty-two cases (29 toes) were followed up 1-6 years (mean, 3.5 years) postoperatively. Two cases (3 toes) felt cool or anaesthesia and could not tolerate even in cold environment. The other toes had no senses of cold pain and paresthesia. Two cases (2 toes) had nonunion and achieved fracture heal ing after grafting bone. The mean union time was 4.5 months (range, 3-6 months) in other cases. Conclusion Intervention assistant operation is an effective measure in the treatment of phalanx closed fracture combined with artery crisis.
Drug addiction has been one of the serious social problems. The peripheral phlebitis caused by drug injection is common, but the occurrence of pseudoaneurysm with infection of femoral artery from injection injury was rarely reported in China. From January 1995 to March 1996, six cases of injury of femoral artery with infection from heroine injection were admitted. The characteristics of the injury were described. The therapeutic measures and details of attention to be needed were discussed. It was concluded that this type of injury was different from the injury caused in agricultural, industrial or traffic accidents. The treatment of choice depended upon the type of injury.
Seventy-four cases of peripheral arterial injuries in recent 30 years were reported. Mostof them were main arteies in extremeties. Twenty-eight cases were performed end to end anastomosis and 7 of them received amputation for various complications. We also performed 12 cases of reparatidn of wall, 20 cases of vascular grafts and 7 cases of arterial ligation. There were 16 cases of amputation and one death. We think that artemal injuries should be operated as soon as possible. Arteial reconstruction was mostly used, including reparation of wall, end-to-end anastomosis and autovenous graft. Other procedures should be emphasized, such as complete debridement of the soft tissue and vessels, appropriate fixation of fracture, exploration and reconstruction of major veins, enough decompression of interfascia compartment, proper drainage of would and good surgical skill. Local and general anticoagulation were good to treatment of arterial injuries during and after operation .
In order to develope a new method to overcome the difficulties in anastomosis of blood vessels with different diameter, phleboplasty was utilized at the join-point to expand the diameter of branched vein graft, with a funnel-shaped stoma formed consequently. After successfully experimented in fresh blood vessels in vitro, the method was practised clinically to repair injured arteries in extremities, with the outcome that phleboplasty of branched vein graft could enlarge the diameter by 1-1.25 times, and with satisfied effects in 3 clinic cases. So, the conclusion was that: phleboplasty of branched vein graft was a new effective and convinient method to repair injured arteries with different diameters
目的 探讨四肢动脉损伤的诊断和治疗方法。方法 回顾分析我院1996年1月至2006年7月共诊治的23例四肢动脉损伤患者的临床资料。分别采用直接动脉修补、动脉结扎、端端吻合、自体大隐静脉移植及人工血管吻合。术中取栓6例,合并静脉损伤修复8例。结果 截肢3例（13.0%）。获得随访12例，随访时间3个月~5年，11例多普勒超声证实损伤血管血流通畅，下肢肌肉挛缩1例； 下肢血供不足1例。结论 早期诊断是提高肢体存活率和避免假性动脉瘤发生的关键。手术方式的合理选择、Fogarty导管常规取栓和早期筋膜切开可提高治愈率。