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. 2021 Aug 13;57(3):455-461.
doi: 10.1055/s-0041-1729574. eCollection 2022 Jun.

Evaluations of Repaired Artery Patency in Forearm Wounds Using the Allen Test, Handheld Doppler and Doppler Ultrasonography

Amanda Favaro Cagnolati  1 , Fernanda Ruiz Andrade  1 , Sara Dadona Correia Serrano  2 , Claudio Henrique Barbieri  2 , Nilton Mazzer  2 , Marcello Henrique Nogueira-Barbosa  3
Affiliations

Evaluations of Repaired Artery Patency in Forearm Wounds Using the Allen Test, Handheld Doppler and Doppler Ultrasonography

Amanda Favaro Cagnolati et al. Rev Bras Ortop (Sao Paulo). .

Abstract

Objective The purpose of the present study was to evaluate the rate of patency in the postoperative period of arterial injuries of the forearm secondary to penetrating trauma. The injuries were subjected to primary repair and examined with the Allen test and a handheld Doppler device, and the results were later confirmed with Doppler ultrasonography. Methods Eighteen patients were included, with a total of 19 arterial lesions, 14 ulnar lesions, and 5 radial lesions; one patient had lesions on both forearms. All patients underwent surgery and three clinical evaluations: the Allen test and assessment of arterial blood flow by a handheld Doppler device at 4 and 16 weeks after surgery and Doppler ultrasonography performed at 12 weeks after surgery. Results At the first clinical evaluation, 77% of the patients had patency based on the Allen test, and 72% had a pulsatile sound identified by the handheld Doppler device. In the second evaluation, 61% of the patients had patency based on the Allen test, and the rate of pulsatile sound by the handheld Doppler device was 72%, similar to that observed 2 months earlier. Based on the Doppler ultrasonography evaluation (∼12 weeks after surgery), the success rate for arteriorrhaphy was 88%. Regarding the final patency (Doppler ultrasonography evaluation) and trauma mechanism, all patients with penetrating trauma had patent arteries. Conclusion We conclude that clinical evaluation using a handheld Doppler device and the Allen test is reliable when a patent artery can be palpated. However, if a patent artery cannot be located during a clinical examination, ultrasonography may be required.

Keywords: arterial injury; arterial patency; arterial repair; doppler; ulnar artery.

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Conflict of interest statement

Conflito de Interesses Os autores não têm conflito de interesses a declarar.

Figures

Fig. 1
Fig. 1
Handheld Doppler device used to evaluate the patients.
Fig. 2
Fig. 2
Assessment of a patient using a handheld Doppler device.
Fig. 3
Fig. 3
Comparison of the initial Allen test with the final ultrasonography evaluation.
Fig. 4
Fig. 4
Comparison of the Allen test in the second evaluation with the final ultrasonography evaluation.
Fig. 5
Fig. 5
Comparison of the initial handheld Doppler evaluation and final ultrasonography evaluation.
Fig. 6
Fig. 6
Doppler ultrasonography examination showing a patent artery after arteriorrhaphy.
Fig. 7
Fig. 7
Doppler ultrasonography examination showing an obstructed artery.
Fig. 1
Fig. 1
Dispositivo Doppler portátil usado para avaliação dos pacientes.
Fig. 2
Fig. 2
Avaliação de um paciente com Doppler portátil.
Fig. 3
Fig. 3
Comparação do primeiro teste de Allen com a última ultrassonografia.
Fig. 4
Fig. 4
Comparação do segundo teste de Allen com última ultrassonografia.
Fig. 5
Fig. 5
Comparação da primeira avaliação com Doppler portátil à última avaliação por ultrassonografia.
Fig. 6
Fig. 6
A ultrassonografia com Doppler revela a artéria pérvia após a arteriorrafia.
Fig. 7
Fig. 7
A ultrassonografia com Doppler revela uma artéria obstruída.
See this image and copyright information in PMC

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