Emergency Angiography in Evaluating the Open Fracture in the Emergency Department

ABSTRACT

PURPOSE: Our study aimes to examine the outcome of open fractures with associated vascular injury and to assess the diagnostic value of angiography in patients who visit the emergency department (ED). METHODS: The records of 22 patients who were diagnosed as open fracture in the ED of Inha University Hospital between June 1996 and December 2001 were selected for review. Angiography was done on the suspicion of vascularinjury for patients with abnormal vascular examination results and an unclear level of injury that might require vascular repair. RESULTS: There were 21 men and one woman with a mean age of 37 years. The injury resulted from traffic accidents in 59.2% of the patients. The femur and tibia were most commonly involved and the popliteal artery was too. 18 patients were confirmed vascular injury by angiography (81.8%). 14 abnormal angiographic findings were found in 15 (93.3%) of the patients who were predicted the vascular injury by clinical findings. 4 abnormal angiographic findings were found in 7 (57.1%) of the patients who were not predicted the vascular injury. The group of patients who had demonstrated vascular injury and repair was performed within 6 hours of injury showed lesser incidence of complication than 6 hours after injury. The overall amputation rate was 22.7% (5 of 22). CONCLUSION: The most important factor in successful management is early recognition and early repair of vascular injury in open fracture. In conclusion, we suggest that emergency angiography is valuable diagnostic procedures for patients who visit the emergency department with the open fracture.