ABSTRACT
Despite recent advances in microsurgery, the incidence of thrombosis of repaired digital
vessels following crush injury is higher than that of uncrushed arteries. The purpose
of this study was to evaluate the effects of traumatic crush injury on uncrushed segments
of artery adjacent to crushed segments. Sprague-Dawley rat-tail arteries were crushed
for 1 hour by 30 pounds of force at two separate 3-mm-wide segments, with 10 mm of
uncrushed artery between segments. Luminal size of the uncrushed segments decreased
progressively over the first 12 hours, with a significant reduction by 4 hours postcrush.
The condition of the arteries continued to deteriorate until, by 24 hours postinjury,
they had been denuded of endothelium, and smooth muscle damage had occurred. Untreated
vasospasm following a multiple-level crush injury therefore results in progressive
endothelial and intimal damage and thrombosis in the intervening healthy uncrushed
segments of artery. This article discusses the implications of these findings.
KEYWORDS
Vascular spasm - crush injury - microsurgery
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Hani S MatloubM.D.
Department of Plastic Surgery, Medical College of Wisconsin
8700 Watertown Plank Road, Milwaukee, WI 53226
