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In Reply.—On behalf of my coauthors, I want to express our appreciation to Drs Braun and Rose for their insightful review of our article. They pose a number of questions that I will try to answer by lumping some of them together in related topics for the sake of brevity.
The patients who underwent angiography and were believed to be normal but who were subsequently found to have injury were determined to have these injuries by exploration. These three patients were treated relatively promptly after their arrival at the hospital. The remainder of the injury cases were detected at intervals of months to several years as clinical problems became evident or on postoperative screening. The diagnosis was confirmed by angiography and/or exploration in all cases.
Numerous questions are raised as to whether any of these missed injuries were related to compartment syndromes. We certainly are well aware of this
RICHARDSON JD. False-negative Angiograms in Missed Vascular Injuries-Reply. Arch Surg. 1988;123(2):259. doi:10.1001/archsurg.1988.01400260146024