日本マイクロサージャリー学会会誌
Online ISSN : 2185-9949
Print ISSN : 0916-4936
ISSN-L : 2185-9949
症例
長い静脈移植を要した Gustilo IIIc 上腕骨開放骨折の 1 例
多田 薫山本 大樹中嶋 宰大中田 美香土屋 弘行
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ジャーナル 認証あり

2017 年 30 巻 2 号 p. 65-68

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A 62-year-old woman exhibited a Gustilo type IIIc open fracture of the right humerus with a long defect of the brachial artery. The injury was due to the patient's upper extremity protruding through a window during a motor vehicle rollover. The patient's overall health status was stable, and reconstruction was attempted. After debridement and external fixation of the humerus, the brachial artery was reconstructed with a reverse great saphenous vein graft of 220 mm in length. The duration of ischemia was 6.5 hours. Graft patency was demonstrated by ultrasonography 10 months after the injury. Most of the brachial artery injuries were caused by puncture wounds to the upper extremity. Our case involved a “hand-out-the-window” injury during a traffic accident. Although there was good collateral circulation around the elbow joint, the patient had a large soft-tissue injury including the brachial artery and its branches; therefore, revascularization with a vein graft was needed for limb salvage.
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