Elbow dislocation associated with vascular injury treated by delayed vascular repair

2005 ◽  
Vol 6 (4) ◽  
pp. 197-198
Author(s):  
S. Joshy ◽  
S. G. Haidar
Keyword(s):  
Vascular Injury ◽  
Elbow Dislocation ◽  
Vascular Repair

Brachial artery transection associated with open elbow dislocation in a 12-year-old: a case report

Vascular ◽  
2011 ◽  
Vol 21 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Yunus Nazli ◽  
Necmettin Colak ◽  
Ismail Uras ◽  
Mahmut Komurcu ◽  
Omer Cakir
Keyword(s):  
Case Report ◽  
Vascular Injury ◽  
Brachial Artery ◽  
Elbow Dislocation ◽  
Limb Ischemia ◽  
Treatment Delay ◽  
Rapid Evaluation ◽  
Vascular Repair ◽  
Orthopedic Injuries ◽  
High Level

Although acute elbow dislocations are common orthopedic injuries, concomitant neurovascular injury is rare. Brachial artery transection can result from open elbow dislocation and responds well to vascular repair. Rapid evaluation and a high level of suspicion are essential to facilitate immediate treatment. Delay to identify vascular injury after elbow dislocation or reduction can potentially lead to limb ischemia, and potential loss of limb. We present a case of relatively rare transection of the brachial artery, with an accompanying traumatic open elbow dislocation in a 12-year-old boy.

scholarly journals Transplantation of EPCs overexpressing PDGFR-β promotes vascular repair in the early phase after vascular injury

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Hang Wang ◽  
Yang-Guang Yin ◽  
Hao Huang ◽  
Xiao-Hui Zhao ◽  
Jie Yu ◽  
...  
Keyword(s):  
Vascular Injury ◽  
Early Phase ◽  
Vascular Repair

scholarly journals Delayed Presentation Of Missed Vascular Injuries And Pitfalls In Primary Treatment– Experience Of A Vascular Surgery Unit In Pakistan

2018 ◽  
Vol 08 (04) ◽  
pp. 258-262
Author(s):  
Ahsin Manzoor Bhatti ◽  
Junaid Mansoor ◽  
Haroon Sabir Khan
Keyword(s):  
Vascular Surgery ◽  
Vascular Injury ◽  
Tertiary Care ◽  
Primary Treatment ◽  
Vascular Trauma ◽  
Adverse Outcomes ◽  
Delayed Presentation ◽  
Vascular Injuries ◽  
Vascular Repair ◽  
Missed Injuries

Objective: To analyze errors in primary treatment of vascular injuries and delayed presentations of missed vascular injuries as a surrogate indicator of need for improved vascular surgical training of upcoming general surgeons. Materials and methods: This retrospective observational study was carried out at vascular surgery department of two tertiary care hospitals of Armed Forces from Jan 2012 to June 2017. Hospital records of all patients with vascular trauma were analyzed for presence of pitfalls in primary treatment and delayed presentation of missed vascular injuries which resulted in redo surgeries or adverse outcomes. Results: Out of 256 patients with vascular injury sequel 41 had either a problem in primary treatment or presented with delayed complications of missed injuries. The omissions can be divided into: missed injuries (24/41), technical errors in initial repair (12/24), reperfusion of mangled Extremity (3/41) and non availability of a surgeon capable of undertaking vascular repair. The commonest operative fault was failure to debride the vessel adequately and vascular repair under tension. The commonest primary assessment problem was failure to timely appreciate hard signs of vascular injury. Conclusion: With better training and emphasizing the need of thorough clinical examination outcome of vascular trauma can be improved.

scholarly journals Cyclic Stretch Induces Vascular Smooth Muscle Cells to Secrete Connective Tissue Growth Factor and Promote Endothelial Progenitor Cell Differentiation and Angiogenesis

2020 ◽  
Vol 8 ◽  
Author(s):  
Jing Yan ◽  
Wen-Bin Wang ◽  
Yang-Jing Fan ◽  
Han Bao ◽  
Na Li ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Growth Factor ◽  
Connective Tissue ◽  
Vascular Injury ◽  
Tissue Growth ◽  
Cyclic Stretch ◽  
Endothelial Differentiation ◽  
Vascular Repair ◽  
Injury Model

Endothelial progenitor cells (EPCs) play a vital role in endothelial repair following vascular injury by maintaining the integrity of endothelium. As EPCs home to endothelial injury sites, they may communicate with exposed vascular smooth muscle cells (VSMCs), which are subjected to cyclic stretch generated by blood flow. In this study, the synergistic effect of cyclic stretch and communication with neighboring VSMCs on EPC function during vascular repair was investigated. In vivo study revealed that EPCs adhered to the injury site and were contacted to VSMCs in the Sprague–Dawley (SD) rat carotid artery injury model. In vitro, EPCs were cocultured with VSMCs, which were exposed to cyclic stretch at a magnitude of 5% (which mimics physiological stretch) and a constant frequency of 1.25 Hz for 12 h. The results indicated that stretched VSMCs modulated EPC differentiation into mature endothelial cells (ECs) and promoted angiogenesis. Meanwhile, cyclic stretch upregulated the mRNA expression and secretion level of connective tissue growth factor (CTGF) in VSMCs. Recombinant CTGF (r-CTGF) treatment promoted endothelial differentiation of EPCs and angiogenesis, and increased their protein levels of FZD8 and β-catenin. CTGF knockdown in VSMCs inhibited cyclic stretch-induced EPC differentiation into ECs and attenuated EPC tube formation via modulation of the FZD8/β-catenin signaling pathway. FZD8 knockdown repressed endothelial differentiation of EPCs and their angiogenic activity. Wnt signaling inhibitor decreased the endothelial differentiation and angiogenetic ability of EPCs cocultured with stretched VSMCs. Consistently, an in vivo Matrigel plug assay demonstrated that r-CTGF-treated EPCs exhibited enhanced angiogenesis; similarly, stretched VSMCs also induced cocultured EPC differentiation toward ECs. In a rat vascular injury model, r-CTGF improved EPC reendothelialization capacity. The present results indicate that cyclic stretch induces VSMC-derived CTGF secretion, which, in turn, activates FZD8 and β-catenin to promote both differentiation of cocultured EPCs into the EC lineage and angiogenesis, suggesting that CTGF acts as a key intercellular mediator and a potential therapeutic target for vascular repair.

scholarly journals Surgical Treatment of an Open Elbow Dislocation with Vascular Injury: A Case Report

2017 ◽  
Vol 34 (1) ◽  
pp. 77-83
Author(s):  
Predrag Stojiljković ◽  
Milan Jovanović ◽  
Ivan Golubović ◽  
Milan Mitković ◽  
Marko Mladenović ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
External Fixation ◽  
Vascular Injury ◽  
External Fixator ◽  
Functional Result ◽  
Wound Care ◽  
Elbow Dislocation ◽  
Stable Fixation ◽  
Elbow Reconstruction ◽  
Neurovascular Structures

SummaryOpen elbow dislocations with vascular injury are rare injuries and they most commonly occur after a fall from a high or in sports accidents. Close anatomic proximity of the joint to the neurovascular structures put them at risk of concomitant injury. The aim of this paper is to present the method of treatment of this severe injury.Herein we present a case of a female patient, 43 years old. She had suffered an open elbow dislocation with vascular injury as a result of a fall from the height of 1.5 meters. Seven hours after sustaining the injury and short preoperative preparation, reposition of the elbow, reconstruction of the vascular injury, adequate surgical treatment of the wound and external fixation of the elbow with the Mitković type external fixator were performed under general anesthesia. Four weeks after elbow stabilization with the external fixation, the external fixator was removed. The neurovascular status and final functional result of the treatment after six mounts were good.Urgent reposition, artery and vein reconstruction, and external fixation are essential in achieving good results in patients with open cubital dislocation accompanied with vascular injury. The Mitković type external fixator provides fast and stable fixation of the elbow after reposition and good conditions for wound care.

scholarly journals AN EXCEPTIONAL CASE OF A POSTERIOR PURE OPEN DISLOCATION OF THE ELBOW WITH RUPTURE OF THE BRACHIAL ARTERY

2020 ◽  
Vol 8 (11) ◽  
pp. 957-963
Author(s):  
Hicham Benomar ◽  
◽  
Mohamed Boussaidane ◽  
Tamdy Adil ◽  
Abdelhay Rabah ◽  
...  
Keyword(s):  
Brachial Artery ◽  
Therapeutic Strategy ◽  
Elbow Dislocation ◽  
Exceptional Case ◽  
Rare Entity ◽  
Vascular Repair ◽  
Venous Graft ◽  
The Stability ◽  
Real Challenge

Pure open dislocation of the elbow remains a very rare entity, being associated with a complete rupture of the brachial artery make it more exceptional, the therapeutic strategy is very discussed. The vascular repair is essentially based on a venous graft which can be collected from different sites, the second challenge is to reduce and maintain the stability of the elbow.The course ofthis different operatory times represents the real challenge in front of that type of traumas. We report a case of a young man admitted in the emergency room with an open pure elbow dislocation with rupture of the brachial artery, treated by a venous graft and reparation of the elbow capsular with an elbow immobilization by an ulno-humeral pin and with a satisfactory evolution in a long term.

scholarly journals Endothelial Cdc42 deficiency impairs endothelial regeneration and vascular repair after inflammatory vascular injury

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Jiawen Lv ◽  
Junchao Zeng ◽  
Fukun Guo ◽  
Yiran Li ◽  
Mengying Xu ◽  
...  
Keyword(s):  
Vascular Injury ◽  
Vascular Repair ◽  
Endothelial Regeneration

scholarly journals The management of a complex elbow injury with transaction of the brachial artery

2017 ◽  
Vol 4 (1) ◽  
pp. 176
Author(s):  
Supreeth Nekkanti ◽  
Arunodhaya Siddartha ◽  
Purushotham Sastry ◽  
Prakash M. ◽  
Anubhav Verma
Keyword(s):  
Vascular Injury ◽  
Brachial Artery ◽  
Elbow Joint ◽  
Traffic Accident ◽  
Road Traffic ◽  
Rare Complication ◽  
Elbow Dislocation ◽  
Posterior Dislocation ◽  
Elbow Injury ◽  
Left Elbow

<p class="abstract"><span lang="EN-IN">Elbow dislocations are commonly encountered cases by orthopaedic surgeon. Vascular injury accompanying an elbow dislocation is a surgical challenge. The authors report a rare complication of complete transaction of the brachial artery following a posterior dislocation of the elbow joint. A fifty-year old male suffered a road traffic accident during which he injured his left elbow. Radiographs confirmed a posterior dislocation of the elbow joint. However the radial and ulnar pulse very not palpable. Arterial doppler confirmed injury to brachial artery. The patient was successfully treated and regained full functional use of his left upper limb. The aim of this report is to help readers understand why a vascular injury occurs following an elbow dislocations. A successful management of such injuries revolves around a prompt clinical diagnosis and early repair.</span></p>

scholarly journals Outcome of vascular repair in lower limb fractures with vascular injury

2017 ◽  
Vol 3 (2g) ◽  
pp. 671-674
Author(s):  
Dr. Ramachandra N Badami ◽  
Dr. M Shantharam Shetty ◽  
Dr. M Ajith Kumar ◽  
Dr. Ashok Shetty ◽  
Dr. Lathika Shetty
Keyword(s):  
Vascular Injury ◽  
Lower Limb ◽  
Vascular Repair ◽  
Lower Limb Fractures ◽  
Limb Fractures

scholarly journals Platelets secrete stromal cell–derived factor 1α and recruit bone marrow–derived progenitor cells to arterial thrombi in vivo

2006 ◽  
Vol 203 (5) ◽  
pp. 1221-1233 ◽  
Author(s):  
Steffen Massberg ◽  
Ildiko Konrad ◽  
Katrin Schürzinger ◽  
Michael Lorenz ◽  
Simon Schneider ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Progenitor Cells ◽  
Vascular Injury ◽  
Bone Marrow Cells ◽  
Vascular Repair ◽  
Critical Signal ◽  
Major Player ◽  
Stromal Cell Derived Factor ◽  
Marrow Cells

The accumulation of smooth muscle and endothelial cells is essential for remodeling and repair of injured blood vessel walls. Bone marrow–derived progenitor cells have been implicated in vascular repair and remodeling; however, the mechanisms underlying their recruitment to the site of injury remain elusive. Here, using real-time in vivo fluorescence microscopy, we show that platelets provide the critical signal that recruits CD34+ bone marrow cells and c-Kit+ Sca-1+ Lin− bone marrow–derived progenitor cells to sites of vascular injury. Correspondingly, specific inhibition of platelet adhesion virtually abrogated the accumulation of both CD34+ and c-Kit+ Sca-1+ Lin− bone marrow–derived progenitor cells at sites of endothelial disruption. Binding of bone marrow cells to platelets involves both P-selectin and GPIIb integrin on platelets. Unexpectedly, we found that activated platelets secrete the chemokine SDF-1α, thereby supporting further primary adhesion and migration of progenitor cells. These findings establish the platelet as a major player in the initiation of vascular remodeling, a process of fundamental importance for vascular repair and pathological remodeling after vascular injury.

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