I read Dr Weaver's letter with great interest. It is discouraging that his group was able to diagnose arterial injuries in only 58% of cases, whereas our study diagnosed 100% of injuries. Weaver's criticism regarding not having all patients undergoing duplex ultrasonography and arteriography is valid and we could have missed an injury. We addressed this issue on pages 1371-1372 of our article. Why are our results better than those in other published reports? It is because we do not treat the duplex scan as a test in isolation. Surgeons have allowed themselves to become removed from diagnostic procedures beyond the physical examination. They often look to the radiologists, who are often handicapped with inadequate data and are not personally examining the patient, for a definitive diagnosis. No diagnostic test can be treated as omnipotent when it is excluded from other patient information.
Duplex scanning for potential vascular