Sixty-two patients with ninety injuries to the radial or the ulnar
artery, or to both of these arteries, had arterial repairs using
microvascular techniques in three medical centers. Twenty-six of the
twenty-eight patients who had an ischemic hand secondary to injuries to
both arteries and a successful operative repair had at least on patent
vessel at follow-up. Of the other two patients, one had an amputation
through the forearm for ischemia of the hand and the other had a viable
hand supplied by collateral vessels, although both the radial and the ulnar
arteries were thrombosed. The over-all success rate for all repairs was 54
per cent. After 47 per cent of the one-artery and 57 per cent of the
two-artery lacerations, the vessels were patent at follow-up. Repairs of
acute sharp transections of the radial artery within thirty-six hours of
injury were most successful. Of the factors other than operative technique
that strongly influence vessel patency after repair, back pressure in the
distal arterial stump and the extent of the ischemia of the hand relative
to its normal blood supply (a function of the completeness of the palmar
arch) appear to be the most important.