<原著>下腿骨々折に伴なう仮性動脈瘤の2例

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Arterial injuries of extremities due to blunt trauma-fracture, dislocation, contusion are seldom to be seen in civilians. Long bone fracture accompanies a varying degree of arterial damage, but injuries to the arteries are usually neglected in the initial stage of fracture treatment. Arterial injuries are of three types. 1) complete severance 2) incomplete severance 3) contusion. Complete severance of the artery does not usually produce excessive bleeding because severed ends of the artery are rapidly occluded by constriction and retraction. On the other hand, in an incomplete severance of the artery, bleeding is often a major problem. The tendency to the massive bleeding arises partially from inability of the severed artery to retract into surrounding tissues where otherwise vasoconstriction and the clotting process bring about a firm thrombosis. There are four compartments in the leg enveloped by a well-defined, strong, inelastic membranes. Therefore, edema and hemorrhage within these closed compartments may lead to compression of the arteries, resulting in ischemic necrosis of the muscles. Symptoms of the partial severance of artery are hemorrhagic shock, hematoma, pulse deficit, bruit and positive angioma. In addition to these symptoms, we advise the following symptoms to be looked for the establishment of diagnosis. 1) local edema persistently remains even after diffuse edema of the leg disappeared. 2) remarkable anemia comparing with severity of the fracture. 3) accompanying nerve paralysis. 4) marked tension of the skin of the leg with tenderness and warmness. The purpose of this paper is to report two cases of false aneurysm of the leg associated with fracture and to emphasize the importance of early diagnosis and adequate treatment.
近畿大学の論文
1977-04-25

<原著>下腿骨々折に伴なう仮性動脈瘤の2例

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