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Reconstruction of the brachial artery in supracondylar humerus fractures and forearm dislocations.

Presented herein is an analysis of the short- and long-term results of the treatment of brachial artery injuries in 25 patients with extension supracondylar humerus fractures and anterior forearm dislocations. The cause of arterial injury was a blunt trauma in 11 patients and contused-crushed wounds in 12 cases. In two patients, iatrogenic injury of the brachial artery occurred after reposition of humerus fractures in other medical institutions. Fourteen patients were admitted to the Department for the first 6 hours from the time of injury, 5 after up to 12 hours, and 6 patients after 12 hours. Decompensation of limb circulation was marked in 2 and subcompensation in 6 patients. In the remaining cases, limb circulation was assessed as compensated. In different medical institutions, the artery was repaired in 4 cases. Operation was complicated by thrombosis in all the cases. Reconstruction of the neurovascular bundle was accomplished under optic magnification in all the patients. The circular suture of the artery was applied in 9, autogenous vein grafting was performed in 7, Y- plasty of the brachial bifurcation in 4, brachioradial bypass grafting in 3, and brachioulnar in 2 cases. Thrombosis of the autogenous vein graft in the short-term postoperative period was identified in 2 patients. Repeated arterial reconstruction appeared successful. The long-term results were followed up in 17 patients over the period as long as 5 years. Anastomosis patency was well preserved in all the cases.