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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(03): 455-461
DOI: 10.1055/s-0041-1729574
Artigo Original

Evaluations of Repaired Artery Patency in Forearm Wounds Using the Allen Test, Handheld Doppler and Doppler Ultrasonography[*]

Article in several languages: português | English
Amanda Favaro Cagnolati 
1   Residência Médica em Cirurgia de Mão, Departamento de Ortopedia e Anestesiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
,
Fernanda Ruiz Andrade
1   Residência Médica em Cirurgia de Mão, Departamento de Ortopedia e Anestesiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
,
Sara Dadona Correia Serrano
2   Programa de Cirurgia de Mão, Departamento de Ortopedia e Anestesiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
,
Claudio Henrique Barbieri
3   Programa de Cirurgia de Mão, Departamento de Ortopedia e Anestesiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
,
Nilton Mazzer
3   Programa de Cirurgia de Mão, Departamento de Ortopedia e Anestesiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
,
Marcello Henrique Nogueira-Barbosa
4   Divisão de Radiologia, Departamento de Imagens Médicas, Hematologia e Oncologia Clínica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Abstract

Objective The purpose of the present study was to evaluate the rate of patency in the postoperative period of arterial injuries of the forearm secondary to penetrating trauma. The injuries were subjected to primary repair and examined with the Allen test and a handheld Doppler device, and the results were later confirmed with Doppler ultrasonography.

Methods Eighteen patients were included, with a total of 19 arterial lesions, 14 ulnar lesions, and 5 radial lesions; one patient had lesions on both forearms. All patients underwent surgery and three clinical evaluations: the Allen test and assessment of arterial blood flow by a handheld Doppler device at 4 and 16 weeks after surgery and Doppler ultrasonography performed at 12 weeks after surgery.

Results At the first clinical evaluation, 77% of the patients had patency based on the Allen test, and 72% had a pulsatile sound identified by the handheld Doppler device. In the second evaluation, 61% of the patients had patency based on the Allen test, and the rate of pulsatile sound by the handheld Doppler device was 72%, similar to that observed 2 months earlier. Based on the Doppler ultrasonography evaluation (∼12 weeks after surgery), the success rate for arteriorrhaphy was 88%. Regarding the final patency (Doppler ultrasonography evaluation) and trauma mechanism, all patients with penetrating trauma had patent arteries.

Conclusion We conclude that clinical evaluation using a handheld Doppler device and the Allen test is reliable when a patent artery can be palpated. However, if a patent artery cannot be located during a clinical examination, ultrasonography may be required.

Keywords

ulnar artery - arterial injury - doppler - arterial patency - arterial repair

* Study developed at the Department of Orthopedics and Anestesiology, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brazil.




Publication History

Received: 10 July 2020

Accepted: 03 November 2020

Article published online:
13 August 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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