Investigation and Comparison of Therapeutic Outcomes Due to Penetrating Vascular Trauma of the Upper and Lower Limbs in Patients Referred to Ahvaz Golestan Hospital Publisher



Ghaedamini H ; Mousavi SM ; Zargar M ; Nazari I ; Fadaei Z ; Ghaedamini A
Source: Trauma Monthly Published:2025

Abstract

Introduction: Limited research has been done on vascular traumas of the upper limb and their comparison with those of the lower limb. This research was conducted to determine and compare the therapeutic outcomes of penetrating vascular trauma of the upper and lower limbs in patients referred to Golestan Ahvaz Hospital in 2024. Methods: This was a descriptive-analytical and prospective study. The sample size was determined using the census (820 participants). Information was obtained through the medical records and entered into the checklist. Primary outcomes included mortality, rehospitalization, amputation, and revascularization interventions, and other outcomes included operative complications and neurological deficits, which were compared in two groups of upper and lower limb injuries. Results: The frequency of arterial involvement (P=0.003), compartment syndrome (P=0.014), and nerve injury (P=0.005) was higher in the upper limb group. The duration of hospitalization in the lower limb group was significantly longer (P=0.003). In treating penetrating arterial injuries, the rate of primary anastomosis (P=0.006) and ligation of arterioles (P=0.039) was significantly higher in the upper limb group. In comparison, the rate of using venous interposition graft (P=0.032) was significantly higher in the lower limb group. In treating venous injuries, the rate of fasciotomy (P=0.031) was significantly higher in the lower limb group. Mortality rate (P=0.023), amputation (P=0.001), need for reoperation (P=0.041), and need for therapeutic fasciotomy (P=0.001) in the lower limb group were significantly higher. At the same time, the frequency of nerve damage (P=0.003) was significantly higher in the upper limb group. Conclusions: The results show a difference between the initial manifestations, management, and surgery and the outcomes of penetrating injury of the upper and lower limbs, which suggests that attention to penetrating injury seems necessary to prevent mortality and morbidity. © 2025 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http:// creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.