Acute vascular injury associated with fracture of the distal radius: a report of 6 cases.

OBJECTIVES

To highlight the potential for vascular injury with fracture of the distal radius.

DESIGN

Retrospective case series.

SETTING

The practices of several orthopaedic hand surgeons.

PATIENTS/

PARTICIPANTS

Six patients with arterial injury as a consequence of fracture of the distal radius: 2 partial lacerations of the radial artery, 2 complete arterial lacerations (1 radial and 1 ulnar), 1 thrombosed radial artery, and 1 thrombosed ulnar artery. There were 4 men and 2 women with an average age of 42 years (range 26-70 years). Three of the fractures were open, and 3 had an associated distal ulnar fracture.

INTERVENTION: Volar open reduction and internal fixation of the distal radius fracture. Ligation or no treatment for 3 arterial injuries and repair or vein graft reconstruction (1 patient) for 3 injuries.

MAIN OUTCOME MEASUREMENTS: Vascular status of the hand.

RESULTS

At an average follow-up of 9 months (range 5-16 months), all patients had a well-vascularized hand, normal capillary refill, and no complaints of vascular dysfunction.

CONCLUSIONS

Vascular complications, once thought rare in association with fracture of the distal radius, may be more frequently recognized as volar exposures are increasingly used. Because most single artery injuries in the wrist and forearm are not associated with ischemia, identification of these injuries is unlikely to affect the functional result or outcome. In the unusual patient with a dysvascular hand after distal radius fracture, arterial reconstruction may be necessary.