Pediatric arterial injuries of the forearm and hand

IntroductionTraumatic injuries of the arteries are rare in children. Operations due to that kind of damage, inherently difficult, become a challenge for a pediatric surgeon.AimThe aim of the study was to present the Center's own experience in treating children with rare penetrating injuries.Material and methodsA review was completed of 10 patients treated between 2009 and 2012 due to penetrating injuries of the forearm and hand with accompanying damage to the radial and/or ulnar artery.Results and discussionThere were 9 boys and 1 girl of average age 15.7 years. Injury of the radial artery was reported in 6 patients, of the ulnar in 2, of both arteries in 1 and of the superficial palmar arch in 1 patient. Partial damage was observed in 4, and complete in 7 arteries. In total, 2 patients were treated by ligation, 8 by arterial repair. In each case damage to the arteries was accompanied by injury of the muscles, and in 1 case additionally of the ulnar and median nerves. Postoperative period nerve deficits were observed in 5 patients; 4 patients were submitted to the follow-up. In 2 of these sensory disorders, slightly worse warmth of the limbs was reported.ConclusionsThe treatment of choice in children should be repair of the damaged vessel, nevertheless ligation of single artery does not determine limb ischemia. Concomitant neural damage determines occurrence of transient and permanent loss of limb function.