• Timothy Craig Hardcastle and Wayne Johnson.
• Department of Surgery, Tygerberg Hospital and University of Stellenbosch, Cape Town, South Africa. tch@sun.ac.za.
• Eur J Trauma Emerg S. 2008 Oct 1;34(5):493-7.

IntroductionA Trauma Vascular Registry was established in 1998. The aim of the study was to review brachial artery injuries.Methods And MaterialsReview of the prospective registry & case-notes of all identified Brachial Artery Injury. Data was captured on a proforma.Results177 brachial artery injuries were identified, 154 (87%) were male, 130 were due to stab wounds (73,4%) while gunshots or other sharp trauma accounted for 27 injuries (16,1%). 17 blunt injuries and 3 other injuries were noted. The mid-brachial artery was injured most frequently (113; 68,3%). Angiograms were only performed in five patients and diagnosis was by clinical examination in the remaining patients. 22% of patients had a concomitant nerve injury, while 9 had humerus fractures. Repair was by vein graft in 92 patients (52%), while a primary repair was performed in 80 (45,2%). Specialist Registrars performed 142 repairs (80,3%). Sixteen patients (9%) required forearm fasciotomy, with four cases of limb loss. Three of the cases of limb loss presented over 6 hours post-injury.Discussion And ConclusionsBrachial artery injuries are the commonest vascular injuries to the limbs, with a good prognosis, provided early repair is undertaken. Arteriography is usually unnecessary and limb loss is low, provided appropriate decompression of a compartment syndrome is performed, however in this group the limb loss rate is 25% compared to the overall of 2%. The repair of a brachial artery is a good training procedure for surgical trainees, associated with a low morbidity.

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