Traumatic injuries to the forearm often involve damage to the radial or ulnar arteries. In isolated single vessel injuries whereby the hand remains perfused, the surgeon is presented with a dilemma: to repair or ligate? This systematic review aims to compare the outcomes between patients who underwent surgical repair or ligation of vessels (PROSPERO: CRD42022311323). A systematic electronic search of Medline, Embase, CINAHL, PubMed, and Cochrane CENTRAL databases was conducted (March 11, 2022). All surgical comparative studies in adults sustaining a single forearm vessel injury with a minimum follow-up period of 12 months were included, evaluated using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) and Critical Appraisal Skills Programme (CASP) tools. Three studies, totalling 80 patients, were included. Pooled long-term patency was 76% (48/63) across both radial and ulnar arterial repair. One study reported that ligated vessels showed a significant reduction in bone mineral density. Another study reported a significantly reduced lean muscle mass (p < 0.01) and strength following ligation. One study reported no difference in pain and cold intolerance between the ulnar artery ligation and repair groups. There is limited high-quality evidence available and significant heterogeneity within the reported outcomes. Our review suggests that repairing single vessel injuries is associated with improved outcomes; however, further high-quality studies on the topic are needed.
Hanrahan et al. (Wed,) studied this question.