Prolonged warm ischemia and limb survival: case report.

A 21-year-old woman sustained a supracondylar crush injury of her arm. The extremity underwent severe ischemia for more than 16 hours after an unsuccessful brachial artery repair. The forearm muscles became rigid and the fingers could not be extended passively. Clinically these findings were felt to be similar to rigor mortis. Despite this dismal picture, secondary revascularization resulted in a highly functional hand with no loss of digits. Desperate attempts at revascularization in isolated extremity injury may be successful, despite prolonged warm ischemia time.