ABSTRACT
A stereotypical pattern of arterial intimal damage has been demonstrated in ratavulsed and crushed injuries. These intimal tears can be found up to 6 cm proximal to the site of injury in avulsion injuries and are found at a delayed time with crush injuries. In both types of injury, circumferential intimal and subintimal tears spaced approximately 1 mm apart were demonstrated. These findings suggest a structural arrangement of the muscular artery wall that predisposes it to a reproducible pattern of damage. Veins undergoing the same avulsion and crushing procedure did not manifest any change. The presence of musculature rings or a weakened medial layer in artery walls after avulsion and crush injuries may influence short term patency and also long-term clinical replantation results.
