IN THE past two years, we have had occasion to evaluate the application of angiography in 45 patients with peripheral or central musculoskeletal trauma in whom signs of arterial injury were present. The examination was done as an emergency procedure during the initial skeletal survey in order to avoid unnecessary delay. This report is an analysis of the traumatic skeletal mechanism that produces arterial damage.
The thoracic aorta is cushioned laterally by each lung. Anteriorly and posteriorly, however, it is in almost direct continuity with the sternum and thoracic vertebra, consequently, it is quite susceptible to crushing injuries with complete rupture and almost instant death.1 A large number of aortic injuries are, however, the result of an entirely different mechanism. Anatomically, the thoracic aorta is relatively immobile at three fixation points: the base of the aorta; the ligamentum arteriosum; and the diaphragmatic opening. During linear deceleration, as occurs