Forearm artery injury

　　The cause of injury of this disease is mostly caused by sharp object injury, in addition, the sharp edges of fractures are also prone to cause injury to adjacent vascular trunks, and the simultaneous involvement of arteries and veins can cause arteriovenous fistula, and it is also easy to cause injury to the accompanying nerve trunks (ulnar nerve, radial nerve and its branches). Among the various artery injuries of the forearm, the incidence of radial artery is high, and the proportion of iatrogenic factors is quite large, mainly due to the injury of the radial artery wall after blood gas analysis and arterial blood pressure observation, which leads to thrombosis.

　　When the main injury is caused by compression, in addition to the injury of the forearm artery, the soft tissue is often affected at the same time, which is prone to the occurrence of the syndrome of forearm muscle interval, which should be paid attention to. Open upper limb artery trauma can lead to massive hemorrhage, and then trigger ischemic shock and other conditions.

　　In addition to local injury symptoms, this disease is mainly manifested by symptoms of impaired blood supply to the hand, including weakened and absent radial artery or ulnar artery pulsation, cold sensation in the fingers, skin hypersensitivity and numbness, etc. If the injury involves the superficial palmar arch, Raynaud's sign may occur in the fingers, and atrophy sign of the hypothenar eminence may also occur.

　　Patients should pay attention to the protection of their forearms in daily life, preventing cuts and scratches on the forearms during play or fights. Generally, the prognosis is good if the brachial artery is unobstructed. If the brachial artery is blocked or ligated, or if there are ischemic changes in the distal limb muscles, permanent disability of the affected limb may occur.

　　Multiple examinations can be performed for forearm arterial injury, but the main examination items are the following two:

　　1, Arterial Angiography

　　Arterial angiography can clearly diagnose vascular injury, the location, and the extent of the injury.

　　2, Color Doppler Ultrasound

　　Color Doppler ultrasound can be used as an alternative to angiography, with high sensitivity and specificity, and can be used as the first-line examination.

　　For patients with forearm arterial injury, a diet should be light, with a focus on fresh vegetables, fruits, and beans. It is advisable to avoid fried, grilled, salty, and sweet foods, and to avoid spicy foods. It is also recommended to avoid allergenic and irritant foods such as fish, shrimp, strong tea, coffee, and alcohol.

　　For the rupture of the radial artery trunk, it is generally necessary to perform repair and functional reconstruction. From most cases, ligation of a single artery trunk has little impact on hand function, but in cases with a缺损 of the palmar arch, it may affect hand function. Therefore, repair should still be attempted unless it is not necessary or in an emergency. When dealing with vascular injuries, depending on the urgency of the injury, it is appropriate to realign and fix the fracture ends while repairing the blood vessels and repairing the vascular bed.

　　Attention should be paid to compartment syndrome in this disease. The mechanism of injury, mainly compression, often involves the soft tissues of the forearm simultaneously, leading to an increased risk of compartment syndrome, which can exacerbate the injury. The incidence of interval muscle groups on the flexor side is particularly high. Once this condition occurs, the interval should be incised and decompressed as soon as possible to avoid loss of hand function.