Treatment of neurovascular injuries in the upper arm.

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Over 18 months have passed since we experienced 7 cases of neurovascular injuries in the upper arm during the past 12 years. An account is given of their follow-up.A ges of the patients at injury vanged from 13 to 52 years, averaging 31.9. Injuries were induced by contusion in 4 cases and by clean cut in 3 cases. Injured vessels and nerves consisted of brachial artery and vein, median nerve, ulnar nerve and radial nerve in 3 cases and of brachial artery and vein, median nerve and ulnar nerin 4 cases. Time of flow inhibition was from 2 to 9 hours, averaging 4 hours and 42 minutes.All cases received neurovacular primary repair. Neurorrhaphy was always epineural and 2 cases of vascular suture needed vein graft.Examination of the results led to the following tendency: the lower the age at injury was, the more favorable the nervous recovery was and the longer the time of blood flow inhibition was, the worse the result was, and especially those cases with such time over 6 hours and great local damages such as incomplete amputation showed poor prognosis with Volkmanns contracture. As various authors described, in terms of injuried condition, cases of clean cut showed better results than those of contusion, and the former cases ours showed more than S3M3.
西日本整形・災害外科学会の論文